COVID-19 Breastfeeding Infant Feeding Breast Milk - Literature Repositoryupdated 21 August

COVID-19, Breastfeeding, Infant Feeding, Breast Milk – Literature Repository
February 1 – August 21, 2020

Key Terms Date Title Journal / Type of Summary & Key Points Specific Observations Full Citation
Published Source Publication
The expected date for the next update is Friday, September 4th, 2020 at 1 pm USA ET. New publications since our last update have been highlighted in YELLOW (51 new ones since August 7t , 2020).
We can explain this relatively high number of new inclusions: we relooked at all the literature again and we selected articles that discussed breast milk and SARS-CoV-2, but also articles that reported on
formula use, feeding difficulties in newborns, and/or that discussed infant feeding recommendations in the context of COVID-19.
Maternal 15-Aug-20 The impact of Midwifery Editorial In this editorial, the authors consider the impact that COVID-19 has had on In this editorial, the Coxon K, Turienzo CF,
health, the coronavirus maternity care in Europe and draw on first-hand accounts from colleagues authors describe the Kweekel L, et al., The Impact
maternity care, (COVID-19) and clinicians in several affected countries to examine similar or different impact that COVID-19 of the Coronavirus (COVID-
Europe pandemic on responses. Commonalities include concerns around PPE, high numbers of has had on maternity 19) Pandemic on Maternity
maternity care in healthcare staff affected by the virus, and steps taken to reduce pregnant care in Europe, and Care in Europe. [published
Europe women’s exposure to health settings by switching to online and telephone examine how those online, 2020 Aug 15].
consultations where possible. Differences emerge in how labor care and countries most affected Midwifery.
choice of delivery location have been planned, the reductions in antenatal have had similar or doi:https://doi.org/10.1016
and postnatal ‘face to face’ care provision, and in promotion of skin to skin different responses. /j.midw.2020.102779
contact and breastfeeding for COVID-19 positive women following birth. They argue that COVID-
While there is evidence suggesting that pregnancy does not increase the 19 will affect maternity
likelihood of developing COVID-19 complications and that vertical care for the foreseeable
transmission appears to be unusual, the authors conclude that additional future.
evidence is needed to definitively support these early indications.
Pregnancy, 10-Aug-20 Clarifying the JAMA Viewpoint In this Viewpoint, the authors argue that the agile reconfiguration of The authors argue that Hu YJ, Wake M, Saffery R.
children, Sweeping Pediatrics existing, large birth cohort studies may be the only way to capture the long- reconfiguration of Clarifying the Sweeping
neonate, health Consequences of term consequences of the COVID-19 pandemic for pregnant women, existing birth cohort Consequences of COVID-19
outcomes, COVID-19 in neonates, and children. They state that there is a need to understand the studies will allow for in Pregnant Women,
public health Pregnant outcomes of the pandemic, both in those with and without an infection as the best evaluation of Newborns, and Children
Women, all will bear the burdens of altered health services, psychosocial stress, and outcomes related to the With Existing Cohorts.
Newborns, and economic downturn. Specifically, the authors emphasize the importance of COVID-19 pandemic in [published online, 2020 Aug
Children With the following issues: the true incidence of COVID-19, mother-to-child pregnant women, 10]. JAMA Pediatr.
Existing Cohorts transmission, breastfeeding recommendations, long-term effects on fetal neonates, and children. doi:10.1001/jamapediatrics.
development/child health, and long-term health services outcomes. They 2020.2395
argue that answering these questions will require an appropriate pregnancy
and birth cohort. Some of these cohorts already exist and are ready to
incorporate a focus on COVID-19. This would provide a sustainable
infrastructure to minimize adverse outcomes associated with the current
pandemic for mothers and infants while maximizing knowledge to help
address future outbreaks.
Neonate, 10-Aug-20 Newborns of Journal of Comment The authors seek to describe their experience caring for newborns of COVID- The authors identified Patil UP, Maru S, Krishnan P,
breastfeeding, COVID-19 Perinatology 19 positive women delivering at a large public hospital in Queens, New York, 45 neonates born to et al. Newborns of COVID-
childbirth, mothers: short- USA. They performed a retrospective cross-sectional study of live births to SARS-CoV-2 positive 19 mothers: short-term
maternal term outcomes women who were tested for SARS-CoV-2 from 19 March-22 April 2020 at mothers in the USA. outcomes of colocating and
health, USA of colocating and their center. Among 118 live births, 45 (38%) neonates were born to SARS- Rooming-in and breastfeeding from the
breastfeeding CoV-2 positive mothers. The majority of positive mothers (27, 60%), were breastfeeding after pandemic's epicenter
from the asymptomatic. Seven (16%) newborns were admitted to the neonatal ICU delivery provided a [published online, 2020 Aug
pandemic's (NICU) due to prematurity or suspected sepsis. None of the 45 newborns critical educational 10]. J Perinatol.
epicenter needed NICU admission for COVID-19-related symptoms. Of those born to opportunity for new doi:10.1038/s41372-020-
SARS-CoV-2 positive mothers, 73% (33/45) co-located with their mothers, mothers to learn 0765-3
including 31 (94%) who were breastfed within one hour of birth. Three strategies to reduce the
newborns tested positive for SARS-CoV-2, and they were monitored in the risk of transmission of
NICU. The authors conclude that in their experience, there were no short-
1
term adverse neonatal outcomes with skin-to-skin care, rooming-in, or SARS-CoV-2 to their
breastfeeding in newborns of SARS-CoV-2 positive mothers. newborn.
Pregnancy, 10-Aug-20 Care Revista Review article This scoping review sought to map the current knowledge on This review summarizes Mascarenhas VHA, Caroci-
neonate, recommendation Latino- recommendations for labor, childbirth, and newborn care in the context of available Becker A, Venâncio KCMP,
management, s for parturient Americana de COVID-19. 19 papers were reviewed and grouped into 2 categories: recommendations for et al. Care
Brazil and postpartum Enfermagem recommendations for labor and delivery, which address indications to management of both recommendations for
women and anticipate delivery, route of delivery, and preparation of staff and birth labor and delivery and parturient and postpartum
newborns during room, and recommendations for post-partum care, which address the post-partum period women and newborns
the COVID-19 breastfeeding, newborn care, hospital discharge, and care provided to the in the context of the during the COVID-19
pandemic: a newborn at home. A table summarizes the recommendations for each of the COVID-19 pandemic. Of pandemic: a scoping review.
scoping review above elements. The authors indicate that further studies are needed to note: the authors Rev Lat Am Enfermagem.
resolve current controversies regarding directed pushing in labor, recommend COVID-19 2020;28:e3359.
instrumental delivery, delayed umbilical cord clamping, and immediate infected mothers to doi:10.1590/1518-
bathing of the newborn. breastfeed provided 8345.4596.3359
that they wear surgical
masks and observe
hand hygiene, and if
impossible, to express
or pump breast milk.
Pregnancy, 10-Aug-20 Effect of the The Lancet Original Research In this prospective observational study, the authors assessed data from In Nepal, institutional Ashish KC, Gurung R, Kinney
stillbirth, COVID-19 Global Health 20,354 pregnant women who gave birth between Jan 1 and May 30, 2020, childbirth reduced by MV, et al. Effect of the
neonatal pandemic from nine hospitals in Nepal. They assessed the number of institutional more than half during COVID-19 pandemic
mortality, response on births, their outcomes, and quality of intrapartum care before and during the COVID-19 response on intrapartum
intrapartum intrapartum the national COVID-19 lockdown. The average weekly reduction in lockdown, with care, stillbirth, and neonatal
care, Nepal care, stillbirth, institutional births during lockdown was 7.4%, with a total decrease of 52.4% increases in institutional mortality outcomes in
and neonatal by the end of lockdown. The risk ratio of preterm birth for during lockdown stillbirth rate and Nepal: a prospective
mortality versus before lockdown was 1·30 (95% CI 1.20–1.40), after adjusting for neonatal mortality. observational study
outcomes in ethnicity, maternal age, and complication during admission. The institutional Several metrics of [published 2020 Aug 10].
Nepal: a stillbirth rate increased from 14 per 1000 total births to 21 per 1000 total quality of care Lancet Glob Health. 2020.
prospective births during lockdown, with an adjusted risk ratio of 1.46 (95% CI 1·13– decreased during doi:10.1016/S2214-
observational 1·89). The institutional neonatal mortality rate increased from 13 deaths per lockdown, including 109X(20)30345-4
study 1000 live births to 40 deaths per 1000 live births, with an adjusted risk ratio fetal heart rate
of neonatal mortality during the lockdown of 3.15 (95% CI 1.47–6.74). monitoring and
During lockdown there was a decrease in intrapartum fetal heart rate breastfeeding within 1
monitoring during labor and a decrease in breastfeeding within 1 hour of hour of birth.
birth, but improvement in skin-to-skin contact and hand hygiene practice.
Pregnancy, 10-Aug-20 Providing The Lancet Commentary This commentary summarizes the findings published by Ashish KC, et al, in a This commentary Karkee R, Morgan A.
maternal maternal health Global Health prospective observational study of intra-partum care, stillbirth and neonatal summarizes findings of Providing maternal health
health, Nepal services during mortality outcomes across 9 hospitals in Nepal from January-May 2020. the impact of the first services during the COVID-
the COVID-19 They describe the timing and effects of COVID-19 lockdown measures. They two months of COVID- 19 pandemic in Nepal
pandemic in note a sharp increase in maternal mortality from March-May 2020, with 19 lockdown on [published online 2020 Aug
Nepal institutional births decreasing by 52.4% over this time frame and women in maternal health 10]. Lancet Glob Health.
relatively disadvantaged ethnic groups being affected more. They show services in Nepal, 2020. doi:10.1016/S2214-
increases in neonatal deaths and institutional stillbirths and decreases in showing increases in 109X(20)30350-8
intra-partum fetal heart rate monitoring and early initiation of maternal mortality,
breastfeeding. The authors comment that the Nepalese Government should neonatal deaths, and
take note of this Article, monitor real-time essential services coverage levels, stillbirths.
2
and be prepared to modify restrictions to enable women to again access
timely and quality maternal health services.
Neonate, NICU, 10-Aug-20 A multicenter European Original article This multi-center cohort study was conducted among newborns born to 125 This cohort study found Oncel MY, Akın IM,
clinical study on Journal of mothers with COVID-19 in 34 neonatal ICUs (NICUs) in Turkey from March a 3.3% prevalence of Kanburoglu MK, et al. A
characteristics, epidemiological Pediatrics 15-June 15, 2020, to evaluate the epidemiological and clinical characteristics COVID-19 infection multicenter study on
vertical and clinical of newborns born to women infected with COVID-19. C-section, prematurity, among infants born to epidemiological and clinical
transmission, characteristics of and low-birthweight infant rates were 71.2%, 26.4%, and 12.8%, mothers with COVID-19. characteristics of 125
Turkey 125 newborns respectively. 8 mothers (6.4%) were admitted to an ICU for mechanical The authors advocate newborns born to women
born to women ventilation, and 6 died (4.8%). A majority of the newborns (86.4%) were for family support to be infected with COVID-19 by
infected with followed in isolation rooms in the NICU. 56.8% were fed with formula, and a part of the care these Turkish Neonatal Society
COVID-19 by 36% with expressed breast milk. 4 of 120 newborns (3.3%) had a positive RT- newborns receive while [published online 2020 Aug
Turkish Neonatal PCR test result, and 5 asymptomatic newborns could not be tested. Although in the NICU under 10]. Eur J Pediatr. 2020;1-
Society samples taken on the first day were negative, 1 neonate became positive on isolation precautions. 10. doi:10.1007/s00431-
the second day and 2 on the fifth day. A sample from deep tracheal aspirate 020-03767-5
was positive on the first day in an intubated case, the fourth case that tested
positive. Based on this cohort study, the maternal mortality, higher rates of
preterm birth and C- section, suspected risk of vertical transmission, and low
rate of breastfeeding show that family support should be a part of the care
in the NICU.
Pregnancy, 10-Aug-20 Impact of The Journal of Original Article This observational longitudinal cohort study of SARS-CoV-2 PCR-positive This observational study Popofsky S, Noor A,
mother-infant Maternal SARS- Pediatrics mothers and their infants at 3 New York City, USA, hospitals from March 25- found lower rates of Leavens-Maurer J, et al.
separation, CoV-2 Detection May 30, 2020, assessed the impact of separation of SARS-CoV-2 PCR-positive breastfeeding both in Impact of Maternal SARS-
breastfeeding, on Breastfeeding mother-newborn dyads on breastfeeding outcomes. Mothers were surveyed the hospital and at CoV-2 Detection on
New York City, Due to Infant by telephone. Of the 160 mother–newborn dyads, 103 mothers were home among mother- Breastfeeding Due to Infant
USA Separation at reached by telephone, and 85 consented to participate. No significant newborn dyads who Separation at Birth
Birth difference was observed in pre-delivery feeding plan between the separated had been separated [published online 2020 Aug
and unseparated dyads (P = .268). Higher rates of breastfeeding were during their 10]. J Pediatr. 2020;S0022-
observed in the unseparated dyads compared with the separated dyads in hospitalization due to 3476(20)30986-0.
the hospital (p<0.001), and at home (p=0.012). 2 mothers in each group maternal COVID-19 doi:10.1016/j.jpeds.2020.08
reported expressed breast milk as the hospital feeding source (5.6% of infection. .004
unseparated vs 4.1% of separated). COVID-19 was more commonly cited as
the reason for change of feeding plan among the separated compared with
the unseparated group (49.0% vs 16.7%, p<0.001). In the setting of COVID-
19, separation of mother–newborn dyads impact breastfeeding outcomes,
with lower rates of breastfeeding both during hospitalization and at home
following discharge compared with unseparated mothers and infants.
postpartum; 9-Aug-20 Skin-to-Skin American Editorial Skin-to-skin contact (SSC) of mothers and neonates offers many benefits, With rare exceptions, Davanzo R, Merewood A,
obstetric; Contact at Birth Journal of including improved bonding, infant blood glucose regulation, and newborn this editorial Manzoni P. Skin-to-Skin
newborn; skin- in the COVID-19 Perinatology temperature stabilization. During the COVID-19 pandemic, some maternity recommends that skin- Contact at Birth in the
to-skin; Era: In Need of units have discouraged SSC, due to concerns for infant exposure/infection. to-skin contact of COVID-19 Era: In Need of
breastfeeding Help! These authors report that no current data support an increased risk of infants and mothers Help! [published online
neonatal COVID-19 infection after SSC, and that the benefits of SSC usually should continue during ahead of print, 2020 Aug
outweigh the theoretical risks. This editorial recommends that, as long as the COVID-19 9]. Am J Perinatol.
infection prevention measures are followed, the only COVID-positive pandemic. 2020;10.1055/s-0040-
mothers who should not practice SSC, are those with such severe cases that 1714255. doi:10.1055/s-
they physically cannot perform it. This agrees with the stance of the World 0040-1714255
Health Organization.
3
Breast milk, 8-Aug-20 Breastfeeding International Case Series The potential for viral transmission from mother to newborn through The authors from a Pereira A, Cruz-Melguizo S,
breastfeeding, mothers with Breastfeeding breastmilk remains uncertain. Consequently, various health organizations study in Spain argue Adrien M, et al.
case series, COVID-19 Journal disagree on breastfeeding management in confirmed COVID-19 patients. In that whenever possible, Breastfeeding mothers with
donor breast infection: a case this retrospective study, authors present a series of representative cases of breastfeeding by COVID-19 infection: a case
milk, infant series 22 newborns delivered by mothers with COVID-19 infections from March COVID-19 confirmed series. Int Breastfeed J.
formula, Spain 14th to April 14th, 2020, in Spain who were then followed for a median mothers should be 2020;15(1):69. Published
period of 1.8 consecutive months. Out of 22 mothers, 20 (90.9%) chose to encouraged at any time. 2020 Aug 8.
breastfeed their infants during hospital admission. Timely initiation and skin- With adequate infection doi:10.1186/s13006-020-
to-skin contact at delivery room was performed in 54.5% and 59.1%, control measures to 00314-8
respectively. 82% of newborns to mothers with COVID-19 were fed with avoid mother-infant
breast milk after 1 month, decreasing to 77% at 1.8 months. Six of 22 contagion,
(37.5%) mothers with COVID-19 required transitory complementary feeding breastfeeding in
until exclusive breastfeeding was achieved. During follow-up period, there newborns of mothers
were no major complications, and no neonates were infected during with COVID-19
breastfeeding. As a result, authors concluded that breastfeeding in infections remains safe.
newborns of mothers with COVID-19 is safe with the adequate infection
control measures to avoid mother-infant contagion, including but not
limited to respiratory hygiene, routine cleaning of surfaces and infant
feeding equipment, and thorough hand washing before and after contact
with the newborn.
Breastfeeding, 6-Aug-20 Breastfed 13 International Case report The authors present the case of a mother who continued breastfeeding her This case report of a Yu Y, Li Y, Hu Y, et al.
infant, mother- month-old infant Breastfeeding 13-month-old child when both were diagnosed with confirmed COVID-19 mother with COVID-19 Breastfed 13 month-old
infant of a mother with Journal pneumonia. They describe the clinical presentation, diagnosis, treatment, who was found to have infant of a mother with
transmission, COVID-19 and outcome. SARS-CoV-2 nucleic acid was found in maternal SARS-CoV-2 IgM and COVID-19 pneumonia: a
China pneumonia: a nasopharyngeal swabs but not serum, breast milk or feces. SARS-CoV-2 IgG antibodies, but not case report [published
case report nucleic acid was found in infant nasopharyngeal swabs and feces but not SARS-CoV-2 nucleic online 2020 Aug 6]. Int
serum. IgM and IgG antibodies against SARS-CoV-2 were found in maternal acid, in her breast milk Breastfeed J. 2020;15(1):68.
serum and breast milk and in infant serum. They conclude that this case adds to the data doi:10.1186/s13006-020-
supports the possibility of mother-to-child transmission of SARS-CoV-2 via supporting the safety of 00305-9
breast milk alone being very small, and that breast milk from mothers with mothers with COVID-19
SARS-CoV-2 infection is safe for direct feeding of infants. breastfeeding their
infants.
Maternal 6-Aug-20 Implications of Journal of Insights into The authors seek to outline the protective influences of breastfeeding on The authors argue that Gribble K, Marinelli KA,
health, mental the COVID-19 Human Practice and infant health during the COVID-19 pandemic. In this article, they describe policymakers should Tomori C, Gross MS.
health, infant, Pandemic Lactation Policy current knowledge concerning SARS-CoV-2 in infants and human milk. They develop guidance for Implications of the COVID-
breastfeeding Response for summarize international and national guidance for newborn care in the maternal caregiving by 19 Pandemic Response for
Breastfeeding, context of the pandemic. They describe the results of policies that prevent considering the risks of Breastfeeding, Maternal
Maternal skin-to-skin contact, isolate or separate mothers and infants on disease transmission as Caregiving Capacity and
Caregiving breastfeeding, maternal caregiving capacity, and infant mental health. They well as the critical Infant Mental Health
Capacity and emphasize that some COVID-19 policies separate infants and mothers, importance of skin-to- [published online, 2020 Aug
Infant Mental preventing or impeding breastfeeding, despite no evidence for vertical skin contact, 6]. J Hum Lact.
Health transmission of SARS-CoV-2 and generally mild symptoms in infants. Further, breastfeeding, and doi:10.1177/089033442094
they argue that policies separating mothers and infants and impeding maternal proximity to 9514
[No Abstract and breastfeeding increase infant morbidity, mortality, and child neglect. Finally, short and long-term
Article not they discuss parallels to the HIV pandemic, ethical considerations, and the infant physical and
available for disproportionate influence of policies undermining breastfeeding and mental health.
free] maternal caregiving on disadvantaged mothers and infants.
4
Breastfeeding, 5-Aug-20 The COVID-19 American Commentary Breastfeeding and human milk are critical to maternal and infant health The authors discuss Palmquist AEL, Asiodu IV,
human milk, liquid gold rush: Journal of outcomes, especially during public health emergencies. Therefore, historical and current Quinn EA. The COVID-19
postpartum, Critical Human recommendations for infant feeding must rely on a complex decision‐making research on human milk liquid gold rush: Critical
neonate perspectives of Biology process. Thus far, there is only limited and low-quality evidence available with a focus on the perspectives of human milk
outcomes human milk and regarding COVID-19 and human milk. Of the COVID‐19+ individuals who had current COVID-19 and SARS-CoV-2 infection
SARS-CoV-2 milk tested, viral RNA was only detected in a small percentage, and repeat pandemic. They argue [published online, 2020 Aug
infection samples from the same individuals did not consistently yield identification of that studying human 5]. Am J Hum Biol.
viral RNA. Further, there is no evidence that this RNA is infectious. milk outside of human doi:10.1002/ajhb.23481
Additionally, there is considerable evidence that the science used to support lived experiences is not
perinatal separation policies for COVID‐19, including those strongly advising only extremely limited
against breastfeeding or provision of human milk in the context of a SARS‐ but potentially harmful
CoV‐2 infection, are disproportionately harming Black, Indigenous, and to vulnerable
People of Color. The authors conclude that ecological studies of human milk, populations.
in which research studies are co‐created with patients and where study
findings are interpreted in the context of lived experiences, are a conceptual
and methodological alternative to more extractive, reductionistic, and racist
scientific approaches.
Vertical 5-Aug-20 Vertical American Review The risk of fetal infection due to maternal-fetal transmission of SARS-CoV-2 The authors summarize Auriti C, Domencio UDR,
transmission, Transmission of Journal of remains highly debated. The detection of SARS-CoV-2 in the amniotic fluid, the current knowledge Tzialla C, et al. Vertical
neonate, SARS-CoV-2 Pediatrics cord blood, and placentas of infected women lends biological plausibility to surrounding SARS-CoV- Transmission of SARS-CoV-2
placenta, cord (COVID-19): Are the theory of vertical transmission. This review provides an overview of the 2 and vertical (COVID-19): Are Hypotheses
blood, amniotic Hypotheses evidence for vertical transmission. The authors searched PubMed for articles transmission. They More than Evidences?
More than relating to vertical transmission and SARS-CoV-2, only articles written in point to the need for [published online 2020 Aug
Evidences? English or Italian were used. Despite viral RNA detection in cord blood and additional studies to 05]. Am J Perinatol. 2020.
placental samples, no definitive reports of maternal-fetal transmission exist. examine the risk of doi: 10.1055/s-0040-
While neonates have tested positive for SARS-CoV-2 after birth, this likely infection based on 1714346.
represents horizontal transmission from an infected mother or health care pregnancy stage as well
worker. IgG and IgM antibodies against SARS-CoV-2 have been found in cord as the need to ascertain
blood, however the affected neonates all tested negative for viral material in long-term health
blood and nasopharyngeal samples. SARS-CoV-2 has not been detected in outcomes for exposed
breast milk samples, which supports recommendations for breastfeeding in neonates.
women with suspected or confirmed infection. However, documentation of
low ACE2 receptor expression in the placenta during early gestation, point to
the need for further research articulating the risk of infection and
transmission at different pregnancy stages.
Pregnancy, 4-Aug-20 Corticosteroids Obstetrics & Current The authors summarize the current evidence supporting steroid therapy in This article provides Saad AF, Chappell L, Saade
corticosteroids, in the Gynecology Commentary the management of patients with acute respiratory distress syndrome guidance on steroid GR, Pacheco LD.
oxygen Management of (ARDS) and COVID-19 and to elaborate on key modifications for the administration in Corticosteroids in the
support, ARDS, Pregnant pregnant patient. Until recently, corticosteroid administration in patients pregnant patients with Management of Pregnant
fetal lung Patients With with COVID-19 was discouraged because of concerns about potentially COVID-19 who are on Patients With Coronavirus
maturity Coronavirus delaying viral clearance. Yet, preliminary evidence from the RECOVERY oxygen support and at Disease (COVID-19)
Disease (COVID- (Randomized Evaluation of COVID-19 Therapy) trial suggests that patients risk for preterm birth. [published online ahead of
19) with COVID-19 who received dexamethasone had a significant reduction in The authors suggest print, 2020 Aug 4]. Obstet
28-day mortality and that this benefit was greatest among patients receiving using Gynecol.
invasive mechanical ventilation, followed by patients receiving supplemental methylprednisolone 2020;10.1097/AOG.000000
oxygen. However, an alternative approach for pregnant women is needed because of its limited 0000004103.
because exposure to repetitive courses of antenatal glucocorticoids has placental transfer and
5
been associated with adverse neonatal outcomes. Therefore, the authors documented efficacy in doi:10.1097/AOG.00000000
propose that when steroids are required for both fetal lung maturity and cases of acute lung 00004103
COVID-19, a four-dose course of dexamethasone over 2 days be used, injury.
followed by methylprednisolone to complete a 10-day course. Furthermore,
if steroids are not indicated for fetal lung maturity or if the mother is
breastfeeding, methylprednisolone can be used for the duration of the
steroid course (10 days or up to discharge, whichever is sooner).
Children, 3-Aug-20 After the First The Pediatric Report COVID-19 was first described in China in December 2019 and declared a The authors state that Galli L, Chiappini E,
adolescents, Wave of COVID- Infectious pandemic by the WHO in March 2020. Italy was the first European country while severe disease, Schumacher R. After the
fatality rate, 19: Reflections Disease to be severely affected. By May 20, more than 227,000 confirmed SARS-CoV- sequelae and death First Wave of COVID-19:
Italy From Italy Journal 2 infections were registered, and more than 31,000 people had died, a much directly due to COVID Reflections From
higher case-fatality rate (13.6%) than reported for China (2%–3%). There was may be rare in children, Italy. Pediatric Infectious
also a concern of a more severe COVID-19 burden in Italian children, as the secondary or Disease Journal.
compared with China where children (<18 years) accounted for only 2.4% of indirect consequences 2020;39(8):e192-e194.
confirmed infections, most of them asymptomatic or with mild disease, and could be far-reaching doi:10.1097/inf.000000000
fatalities in children were only anecdotally reported. In Italy, there are an and more important. It 0002806
estimated 1 million children with comorbidities and each year about 11,000 is imperative to contain
children and adolescents (0–19 years) progress to terminal illness (Italian the virus and ensure
Society of Pediatrics). The role of children in the spread of the pandemic proper practices to
remains unclear. In general, they tend to be less symptomatic despite having prevent further spread.
a similar viral load in upper respiratory tract specimens as adults and
shedding virus for up to 21 days. COVID-19 is a novel disease, and robust
data on short- and long-term courses and outcomes are still lacking. Thus, a
high level of suspicion for yet undescribed but important complications is
warranted. The authors state that possibility of mother-to-child transmission
through delivery or breastfeeding has not yet been clearly established.
Neonatal, 3-Aug-20 Neonates in the Pediatrics Commentary While the COVID-19 pandemic has predominantly affected adults sparing The authors provide Molloy EJ, Lavizzari A,
international COVID-19 Research infants and neonates from severe infection, the long-term effects and commentary about the Klingenberg C, et al.
collaboration, pandemic sequalae of perinatal SARS-CoV-2 exposure are unknown. Even though impact of the COVD-19 Neonates in the COVID-19
registry studies have identified viral RNA in placental membranes and breast milk, pandemic on neonatal pandemic [published online
definitive vertical transmission remains ambiguous. Breast milk of mothers care and call for ahead of print, 2020 Aug 3].
who contracted COVID-19 may also provide antibodies against SARS-CoV-2 increased global Pediatr Res.
in the perinatal period. The authors note that this rapidly evolving situation collaboration within this 2020;10.1038/s41390-020-
has led to a wide variation in the recommendations for the medical and unprecedented 1096-y.
social management of infants born to SARS-CoV-2 positive mothers. During situation. This doi:10.1038/s41390-020-
this time, NICUs have faced additional obstacles, such as decreased financial, collaboration will build 1096-y
spatial, and medical resources. However, the challenges of the pandemic an evidence-based
have led to international collaboration between neonatal providers and neonatal disaster
researchers, in the form of large registry studies and multi-center clinical response system and
trials. The authors propose using this as an opportunity to develop and develop a
maintain an international neonatal collaborative working group, which comprehensive
already includes over 90 countries, to further addresses neonatal disaster neonatal registry
preparedness. database.
6
Breastfeeding, 3-Aug-20 Impact of COVID- The Lancet Correspondence Anecdotal evidence suggests that some health facilities are separating This analysis highlights McClure EM, Kinney MV, et
LMICs, 19 on maternal newborns from mothers and discouraging breastfeeding because of the need for continued al. Impact of COVID-19 on
morbidity, and child health unfounded fears of transmission of COVID-19 through breastmilk. These support to promote and maternal and child health.
newborns situations might result in a decline in early initiation of breastfeeding after protect breastfeeding The Lancet. 2020. Available
birth—missing the child's first natural vaccine (colostrum)—and, in turn, by revealing substantial online 3 August 2020.
exclusive breastfeeding. The authors estimate, using the Alive & Thrive cost morbidity and mortality doi.org/10.1016/S2214-
of not breastfeeding tool, that a hypothetical effect of small (5%), moderate repercussions from 109X(20)30326-0
(10%), medium (25%), or severe (50%) relative reductions in the prevalence possible pandemic-
of breastfeeding due to COVID-19 disruptions would result in 16,469 (small related disruptions to
reduction), 32,139 (moderate reduction), 75,455 (medium reduction), and breastfeeding.
up to 138,398 (severe reduction) child deaths across 129 LMICs over a 1-year
period.
Pregnancy, 3-Aug-20 PrEP retention The Lancet Correspondence In sub-Saharan Africa, HIV risk is high during pregnancy and breastfeeding In a study of HIV Davey DLJ, Bekker LG,
postpartum, and prescriptions and could increase during the COVID-19 pandemic because of reduced negative pregnant and Mashele N et al. PrEP
public health, for pregnant access to HIV prevention and treatment services. Pre-exposure prophylaxis post-partum women in retention and prescriptions
HIV, PrEP, women during (PrEP) is an essential and effective prevention intervention during pregnancy South Africa, missed for pregnant women during
South Africa COVID-19 and the post-partum period. The authors evaluated the effect of the national appointments for pre- COVID-19 lockdown in
lockdown in COVID-19 lockdown in South Africa on study visits and PrEP prescriptions exposure prophylaxis South Africa. [published
South Africa among pregnant women in antenatal care. From August 2019 to June 2020, (PrEP) increased during online, 2020 Aug 3]. The
455 HIV negative pregnant women (aged > 16 years old) were enrolled. a nationwide lockdown Lancet.
During the nationwide lockdown, missed PrEP visits increased significantly to due to the COVID-19 doi:https://doi.org/10.1016
63% at the 1-month visit and to 55% at the 3-month visit. The relative risk of pandemic. Participants /S2352-3018(20)30226-5
missing a study visit increased during lockdown compared with before cited fear of COVID-19
lockdown (odds ratio: 2.36, 95% CI: 1.73–3.16). The authors conclude that and contact with the
these data indicate the profound effect that the South African response to health facility as
the COVID-19 pandemic might have on HIV prevention efforts. common barriers.
COVID-19; 3-Aug-20 Neonatal COVID- Multidisciplina Case Report The authors report the first case of COVID-19 pneumonia in a preterm Premature infants born Abasse S, Essabar L, Costin
preterm 19 Pneumonia: ry Digital neonate born in Mayotte, France, in which vertical transmission is to mothers with a T, et al. Neonatal COVID-19
neonate; Report of the Publishing suspected. After admission to the delivery emergencies unit for active labor COVID-19 infection may Pneumonia: Report of the
pneumonia; First Case in a Institute at 33 weeks of gestation, a 36-year-old multiparous woman tested positive also have a COVID-19 First Case in a Preterm
vertical Preterm for COVID-19. Following immediate transfer to the neonatal ICU where he infection, presumably Neonate in Mayotte, an
transmission; Neonate in was in a closed incubator, the newborn tested positive for COVID-19 at 24 via vertical Overseas Department of
length of stay Mayotte, an hours of life. The authors presume that preterm labor is linked to the transmission. This case France. Children (Basel).
Overseas mother's COVID-19 infection and that the mode of transmission in this case report emphasizes the 2020;7(8):E87. Published
Department of is most likely to be vertical given the short time it took for the neonate to need for a cautious and 2020 Aug 3.
France become COVID-19 positive after delivery and the absence of contact with close follow-up period doi:10.3390/children708008
the mother after delivery as she was symptomatic. Breastfeeding was for asymptomatic 7
excluded as the route of transmission as the infant was exclusively formula neonates born to
fed. By 14 days of life, the infant developed a fever with progressive signs of mothers with COVID-19
increased breathing difficulties. A thoracic computed tomography scan infection.
revealed bilateral ground glass opacities and consolidations, and
echocardiography showed a mild pericardial effusion (3 mm). This case
emphasizes the need for a cautious and close follow-up period for
asymptomatic neonates born to mothers with COVID-19 infection as
worsening respiratory symptoms may appear secondarily
7
Pregnancy, 2-Aug-20 Early-onset Infection Case Report This case report describes early-onset, severe COVID-19 course in a neonate. This case report Kulkarni R, Rajput U, Dawre
neonate, symptomatic A mother, who tested negative by RT-PCR but tested positive for SARS-CoV-2 presents a strong R, et al. Early-onset
vertical neonatal COVID- by serology, delivered a term baby. The neonate was kept in strict isolation. possibility of vertical symptomatic neonatal
transmission, 19 infection with Molecular tests for SARS-CoV-2 on the umbilical stump, placenta, and transmission from a COVID-19 infection with
India high probability nasopharyngeal aspirate of the neonate, collected at the time of birth, were mother with serology high probability of vertical
of vertical positive. On day 2, the neonate developed clinical features of COVID-19 in positive for SARS-CoV-2 transmission [published
transmission the form of fever, poor feeding, and hyperbilirubinemia along with elevated antibodies to a neonate online 2020 Aug 2].
inflammatory markers. A clinical diagnosis of neonatal sepsis was made, and who developed Infection. 2020.
antibiotics were provided. Blood, CSF, and urine cultures were sterile. The symptomatic COVID-19 doi:10.1007/s15010-020-
neonate tested RT-PCR positive for SARS-CoV-2 on two more occasions infection. 01493-6
before testing positive for antibodies and was discharged on day 21 of life.
This report presents a case with strong possibility of vertical transmission of
COVID-19 from a mildly symptomatic, RT-PCR negative but antibody-positive
mother.
Breastfeeding, 1-Aug-20 Skin-to-Skin Care Pediatrics Article Many physicians and mothers find themselves weighing the unknown risk of This article weighs the Boscia C. Skin-to-Skin Care
skin-to-skin and COVID-19 transmitting SARS-CoV-2 against the known costs of separation from an known benefits of skin- and COVID-19. [Published
contact, infant during the first days of life. The American Academy of Pediatrics to-skin contact and online, 2020 Aug 1].
neonatal care, recommends mothers with COVID-19 to physically separate from the infant breastfeeding with Pediatrics.
neonates, whenever space allows, while the WHO encourages breastfeeding initiation infants during the first 2020;146(2):e20201836.
childbirth, within an hour of birth and routine newborn care with emphasis on days of life against doi:10.1542/peds.2020-
patient respiratory and hand hygiene. Limited evidence suggests risk of transmission incomplete evidence 1836
education, from mother to child is low; therefore, the potential benefit of isolation does that suggests low risk of
not necessarily justify denying the known health benefits of skin-to-skin SARS-CoV-2
contact and breastfeeding. The author recommends policies that allow for transmission. The
patient choice in light of incomplete evidence and calls for maternal author recommends
protections that minimize risk before and after delivery such as paid informed patient
parental leave and safety-net programs for vulnerable families. choice.
Pregnancy, 31-Jul-20 Perinatal COVID- Revista Original Article The authors aimed to evaluate and to report the clinical characteristics and The authors evaluated Sola A, Rodríguez S, Cardetti
neonates, C- 19 in Latin Panamericana outcomes of SARS-CoV-2 infection in pregnant women and newborns in pregnancy outcomes of M, Dávila C. COVID-19
section, America de Salud Latin America. Of 86 pregnant women with COVID-19 in seven countries, 59 COVID-19 patients in perinatal en América Latina
breastfeeding, Publica patients (68%) were asymptomatic. Among symptomatic women (27/86, Latin America (n=86). [Perinatal COVID-19 in Latin
Latin America [Article available 32%), 24 patients (89%) had mild symptoms and three (3.5%) had severe Due to their findings, America]. [published online,
in Spanish only] respiratory symptoms. No deaths were reported. The C-section rate was they urge health care 2020 Jul 31]. Rev Panam
38%. Gestational age was < 37 weeks in 6% of cases. Six neonates (7%) were teams to reflect on the Salud Publica.
positive upon testing between 16-36 hours of age, and they all presented need to support doi:10.26633/RPSP.2020.47
mild and transient respiratory distress. Breastfeeding was authorized in only humanized and family-
24% of mothers. In 76% of cases, the mother-child pair was separated, In centered care during
95% of cases, the mother was not accompanied at delivery or during the the current pandemic.
postpartum period. The authors found that the lack of maternal support, the
low rate of breastfeeding, and the frequent separation of mother-child
dyads were concerning.
8
Pregnancy, 27-Jul-20 Review of Acta Review article This systematic review examined how applicable national and regional This review of national Yeo KT, Oei JL, De Luca D, et
mother-infant guidelines and Paediatrica clinical practice guidelines and recommendations for managing neonates and regional clinical al. Review of guidelines and
separation, recommendation born to mothers with COVID‐19 were to the evolving pandemic. This review practice guidelines and recommendations from 17
breastfeeding s from 17 identified 20 guidelines and recommendations from 17 countries that had recommendations for countries highlights the
countries been published by 25 May 2020. The documents were based on expert managing neonates challenges that clinicians
highlights the consensus with limited evidence and were of variable, low methodological born to mothers with face caring for neonates
challenges that rigor. Most did not provide recommendations for delivery methods or COVID-19 found that born to mothers with
clinicians face managing symptomatic infants. None provided recommendations for post‐ the available guidelines COVID-19 [published online
caring for discharge assimilation of potentially‐infected infants into the community. were of low, variable 2020 Jul 27]. Acta Paediatr.
neonates born to The majority encouraged keeping mothers and infants together, subject to quality and may be 2020.
mothers with infection control measures, but one‐third recommended separation. unsustainable. doi:10.1111/apa.15495
COVID-19 Although breastfeeding or using breastmilk were widely encouraged, two
[Free Access to countries specifically prohibited this. Practice guidelines should emphasize
Abstract Only] the extent of uncertainty and clearly define gaps in the evidence.
Breastfeeding, 25-Jul-20 Mistakes from International Commentary The authors share concerns that in many countries, policymakers and Policies against Gribble, K., Mathisen, R.,
transmission, the HIV Breastfeeding practitioners are giving more weight to the risk of SARS-CoV-2 transmission breastfeeding during Ververs, M. et al. Mistakes
breast milk, pandemic should Journal than to the consequences of maternal separation and reducing the HIV pandemic had from the HIV pandemic
infant health, inform the breastfeeding. During the HIV pandemic, policies moved away from devastating effects on should inform the COVID-19
policy COVID-19 breastfeeding over concerns of HIV transmission but had a devastating infant mortality. The response for maternal and
response for impact on infant mortality in many middle- and low-income countries. More authors caution against newborn care. Int
maternal and infants lost their lives through diarrhea and pneumonia related to infant similar policies during Breastfeed J 15, 67 (2020).
newborn care formula feeding than those who lost their lives through HIV infection. the SARS-CoV-2 https://doi.org/10.1186/s13
Additionally, the transmission of SARS-CoV-2 is through respiratory droplets, pandemic, especially 006-020-00306-8
and although a small number of cases detected viral SARS-CoV-2 RNA since breastfeeding is
particles in expressed breastmilk, no live virus has been found and not thought to carry
breastmilk is not thought to be a transmission route. Even when major risk.
transmission occurs, it rarely causes complications or death for the neonate.
The current WHO guidelines support breastfeeding or use of expressed
breast milk during maternal COVID-19 infection, with proper hygiene
precautions. The authors conclude that the substantial evidence of the
importance of maternal proximity and breastfeeding for child survival,
development, and health should not be ignored to avoid repeating the
mistakes of the HIV pandemic.
Neonatal, 23-Jul-20 Neonatal The Lancet. Articles This observational cohort study aimed to elucidate best practices regarding To authors’ knowledge, Salvatore CM, Han JY, Acker
vertical management Child & infection control in mother–newborn dyads and identify potential risk this was the largest KP, et al. Neonatal
transmission, and outcomes Adolescent factors associated with transmission. Of 1481 deliveries between March cohort of neonates management and outcomes
pregnancy, USA during the Health 22nd and May 17th 2020 at three New York Presbyterian Hospitals in New born to mothers during the COVID-19
COVID-19 York City, USA 116 (8%) mothers tested positive for SARS-CoV-2; 120 positive for SARS-CoV-2 pandemic: an observation
pandemic: an neonates were identified. Mothers could practice skin-to-skin care and at the time of delivery, cohort study [published
observation breastfeed in the delivery room, but had to wear a surgical mask when near with prospective follow- online, 2020 Jul 23]. Lancet
cohort study their neonate and practice proper hand hygiene before skin-to-skin contact, up up to 1 month of life Child Adolesc Health.
breastfeeding, and routine care. All neonates were tested at 24 h of life and and prospective real- doi:10.1016/S2352-
none were positive for SARS-CoV-2. 82 (68%) neonates completed follow-up time PCR testing for 4642(20)30235-2
at day 5–7 of life. Of the 82 neonates, 68 (83%) roomed in with the mothers. SARS-CoV-2 was
All mothers were allowed to breastfeed: at 5–7 days of life, 64 (78%) were negative in all 63
still breastfeeding. 79 (96%) of 82 neonates had a repeat PCR at 5–7 days of neonates tested at 1
life, which was negative in all; 72 (88%) neonates were also tested at 14 days week and 2 weeks of
9
of life and none were positive. None of the neonates had symptoms of life. None of the
COVID-19. Findings suggested that perinatal transmission of COVID-19 is neonates had
unlikely to occur if correct hygiene precautions are undertaken, and that symptoms of COVID-19
allowing neonates to room in with their mothers and direct breastfeeding as of 1 month of age.
are safe procedures when paired with effective parental education of infant
protective strategies.
Pregnancy, 23-Jul-20 Management of The Lancet Comment Guidance regarding the care of neonates whose mothers have confirmed or The author describes Medvedev MM.
delivery, mother-newborn suspected COVID-19 is conflicting. In this article, the author provides the main findings of the Management of mother-
childbirth, dyads in the commentary on the article by Salvatore et al. 2020 on the results of their mother-neonate dyad newborn dyads in the
neonate, USA COVID-19 era observational cohort study in New York, USA of 120 neonates born to 116 observational study by COVID-19 era [published
mothers who were positive for SARS-CoV-2. The author describes the key Salvatore et al. 2020. online, 2020 Jul 23]. Lancet
findings of the article by Salvatore et al. 2020 for the management of and The study showed that Child Adolesc Health.
infection control in mother-neonate dyads during the COVID-19 pandemic. perinatal SARS-CoV-2 doi:10.1016/S2352-
Subsequently the author summarizes key messages from the study, such as transmission was 4642(20)30241-8
that rooming-in of newborns and breastfeeding were found safe when unlikely.
accompanied by mask-wearing and frequent hand and breast hygiene
practices. Another key finding was that no neonates tested positive for
SARS-CoV-2, and all remained asymptomatic. The author of this comment
concludes that there remain several important questions regarding
pregnancy and neonate outcomes as well as transmission rates of SARS-CoV-
2 in these populations during the COVID-19 pandemic.
Surveillance, 23-Jul-20 COVID-19 in Indian Journal Commentary This commentary provided a brief analysis of COVID-19 in different age The commentary briefly Kulkarni SV, Chauhan H.
pediatric, Different Age of Pediatrics groups of children in India based on national disease surveillance data. The analyzed the data from COVID-19 in Different Age
national, India Groups of data revealed that the economically productive age group (21-50 years old) national COVID-19 Groups of Children: Initial
Children: Initial accounted for most (60%) of the total cases in the country, followed by surveillance data in Impression from Integrated
Impression from those below 20 years of age (13%). The majority of the reported cases India and stated a need Disease Surveillance
Integrated among children were older than 5 years. The authors stated that information for further studies, Programme (IDSP) under
Disease on clinical presentation and disease severity among neonates was very especially studies on National Centre for Disease
Surveillance limited. The reported signs among the limited number of neonates with the pediatric age group. Control (NCDC) [published
Programme confirmed SARS-CoV-2 infection included fever, cough, tachypnea, strenuous online, 2020 Jul 23]. Indian J
(IDSP) under breathing, vomiting, diarrhea, lethargy, rhinorrhea, and feeding difficulties. Pediatr.
National Centre The authors concluded that further studies are needed about the virus and doi:10.1007/s12098-020-
for Disease its manifestations, especially among the pediatric age group. 03457-y
Control (NCDC)
Pregnancy, 23-Jul-20 COVID-19 in a Infection, Case Report The authors describe the case of a 42-year-old transgender patient G2P1 This case demonstrates Walczak A et al. COVID-19 in
Cystic Fibrosis, Complex Disease, and (genetically female, identifying as male) at 39 + 3 weeks gestation with that patients with cystic a Complex Obstetric Patient
Australia Obstetric Patient Health underlying cystic fibrosis, admitted to a Tertiary hospital in Queensland fibrosis and pregnancy with Cystic Fibrosis.
with Cystic Australia for respiratory symptoms. Of note, his female partner was can have favorable Infectious Disease & Health.
Fibrosis admitted the day prior with symptoms following international travel and outcomes in the setting 2020;
tested positive for SARS-CoV-2. Consequently, the patient’s test results of COVID-19. These DOI:https://doi.org/10.1016
returned as positive for SARS-CoV-2 by RT-PCR on day 3 of admission. His patients should be /j.idh.2020.07.002
clinical course was managed by a multidisciplinary team and included daily managed by a
chest physiotherapy for sputum clearance and close monitoring of his multidisciplinary team
respiratory function. The patient subsequently underwent induction of labor to ensure optimal care,
at 40 + 1 weeks gestation and delivered a healthy baby by spontaneous including infection
vaginal delivery. In consideration of the family’s wishes, the patient’s partner control to prevent
was supported to attend the birth with the use of PPE. Post-delivery, the transmission, and
10
patient remained stable with reduction in sputum, with no antibiotics or consideration of
corticosteroids required. Of note, SARS-CoV-2 remained detectable on day 8 parental wishes with
of admission. However, no transmission to the neonate was detected regards to delivery and
despite immediate and ongoing contact post-delivery with SARS-CoV-2 care of the neonate
antibodies detectable in the patient's serum and breast milk. The patient following birth.
was discharged for self-isolation on post-partum day 3 and his SARS-CoV-2
RNA levels were undetectable at the time of discharge.
Pregnancy, 23-Jul-20 Perinatal Journal of Case Series The authors describe the perinatal management of the first ten consecutive In this case series of ten Pissarra S, Rosário M,
transmission, management of Maternal- mother-infant dyads with pregnancy complicated by SARS-CoV-2 infection at pregnancies Moucho M, Soares H.
perinatal SARS-CoV-2 Fetal and the time of delivery in a Level 3 hospital in Portugal. After delivery, one complicated by Perinatal management of
management, infection in a Neonatal mother was admitted to the ICU for 48 hours and placed under high flow maternal SARS-CoV-2 SARS-CoV-2 infection in a
breastfeeding, level III Medicine oxygen therapy with a favorable outcome. All newborns were transferred in infection at the time of level III University Hospital
Portugal, Spain University a closed incubator to the NICU. Using a shared-decision making model, nine delivery in Portugal, [published 2020 Jul 23]. J
Hospital mothers chose to stimulate lactation with pump extraction under strict there was no evidence Matern Fetal Neonatal Med.
[Free Access to infection control measures and all of these women chose to discard of vertical or horizontal 2020;1-4.
Abstract only] extracted milk until RT PCR SARS-CoV-2 negativity. One mother chose not to transmission. Infants doi:10.1080/14767058.2020
stimulate lactation. All newborns remained symptom free and tested were separated and not .1786526
negative for SARS CoV2 at birth and at 48 hours of life. In this case series fed breastmilk until
there was no evidence of vertical transmission of SARS-CoV-2 infection. maternal testing was
Since all the mother-infant dyads were separated, no case of horizontal negative.
transmission occurred. No expressed milk was given to newborns until
negative testing for maternal SARS-CoV-2 was confirmed.
Breastfeeding, 21-Jul-20 Protecting American Review Article The authors describe variable breastfeeding recommendations for suspected The authors Cheema R, Partridge E, Kair
mother-infant Breastfeeding Journal of or confirmed mothers with COVID-19 resulting from incomplete knowledge recommend direct LR, et al. Protecting
separation, during the Perinatology about COVID-19 transmission. Due to the potential concern for transmission breastfeeding with Breastfeeding during the
mother-infant COVID-19 of infection from maternal respiratory secretions to the newborn, temporary appropriate hygiene COVID-19 Pandemic
transmission, Pandemic separation of the maternal-infant dyad has been variably recommended, precautions, unless the [published online 2020 Jul
California, USA which can have negative health and emotional implications for both mother maternal or neonatal 21]. Am J Perinatol. 2020.
and infant. Two publications have reported SARS-CoV-2 in human breast health condition doi:10.1055/s-0040-
milk, but the role of breast milk as a vehicle of transmission of COVID-19 to warrants separation of 1714277
newborns remains unclear. Breast milk may be providing protective this dyad.
antibodies against SARS-CoV-2 infection even in infected neonates. Given
the overall safety of breast milk and both short-term and long- term
nutritional, immunological, and developmental advantages of breast milk to
newborn, the authors recommend that breast milk should not be withheld
from an infant. The setting of maternal care, severity of maternal infection
and availability of resources can impact the decision of breastfeeding. The
role of shared decision making on breastfeeding between mother and
physician needs to be emphasized.
Pregnancy, 21-Jul-20 Vertical The Journal of Review Article The authors sought to review the current evidence on the vertical The authors conclude Deniz M, Tezer H. Vertical
vertical transmission of Maternal- transmission of SARS-CoV-2 through a search of online databases of the that there is potential transmission of SARS CoV-2:
transmission, SARS CoV-2: a Fetal & published literature. They included 50 studies in this review, which included for vertical transmission a systematic review.
placenta, systematic Neonatal data from 606 neonates. Among these, 17 newborns tested positive for of SARS-CoV-2 due to [published online, 2020 Jul
neonate, breast review Medicine SARS CoV-2 by RT-PCR. In three neonates, SARS-CoV-2 IgG and IgM levels detection of viral RNA in 21]. Matern Fetal Neonatal
milk [Free Access to were elevated. Eight placental tissues tested positive for the virus. Three placental tissues. They Med.
Abstract only] positive RT-PCR results of test of breast milk were also recently reported. also review the current doi:https://doi.org/10.1080
One sample of amniotic fluid tested positive. The authors conclude that evidence of adverse /14767058.2020.1793322
11
possible vertical transmission of SARS CoV-2 has been observed; however, fetal and maternal
more RT-PCR tests on amniotic fluid, placental tissue, breast milk, and cord outcomes associated
blood are required. with SARS-CoV-2 due to
its effects on the
placenta.
Breastfeeding, 20-Jul-20 Providing medRxiv Preprint An online survey conducted from 16 March to 18 May 2020 was completed The findings of this Hull, N, Kam, L, Gribble, K.
access to care, breastfeeding (not peer- by Australian Breastfeeding Association (ABA) volunteers to assess the study suggest that the Providing breastfeeding
maternal support during reviewed) concerns of mothers seeking breastfeeding support during the COVID-19 COVID-19 pandemic has support during the COVID-
concerns, the COVID-19 pandemic as well as the experiences of volunteers who assisted them. The impacted the concerns 19 pandemic: Concerns of
Australia pandemic: online survey was completed 211 times and described the concerns of 340 Australian women have mothers who contacted the
Concerns of individual contacts. The most common breastfeeding concerns were related toward breastfeeding Australian Breastfeeding
mothers who to insufficient milk or weight gain, painful breasts, re-lactation, and reducing practices, especially Association. [published
contacted the supplemental milk (infant formula). Concerns about milk supply and infant without access to face- 2020 July 20] medRvix. doi:
Australian weight gain were exacerbated by lack of health care access and the inability to-face healthcare 10.1101/2020.07.18.201522
Breastfeeding of infants to be weighed. 129 (61%) of mothers informed volunteers they services. 56
Association were unable to access face-to-face health services because of fear or
unavailability. Volunteers reported feeling distressed for mothers but well
equipped to assist and were satisfied providing assistance.
Low- and 19-Jul-20 Foreseeing a Journal of Letter During this pandemic, governments enforced lockdown restrictions to This article presents Sajid MI, Tariq J, Waheed
middle- income worsening of Pediatric contain the spread of COVID-19. However, low- and middle- income that child malnutrition AA, Dur-E-Najaf, Balouch SS,
countries, pediatric Nursing countries (LMICs) such as Pakistan have a large majority of the population in Pakistan is worsening Abaidullah S. Foreseeing a
children, malnutrition who are either daily wagers or depend on their weekly incomes to feed their during the pandemic worsening of pediatric
malnutrition, following SARS- families. Many families are now expected to be pushed towards starvation, and calls for efforts to malnutrition following
Pakistan CoV-2 in low and rendering children more vulnerable to an already prevailing malnutrition. A prevent child wasting SARS-CoV-2 in low and
middle-income study shows that approximately 66% of the children in Pakistan suffer from and ensure the healthy middle-income countries
countries such as malnutrition, ranging from mild malnutrition to severe malnutrition. growth of children such as Pakistan [published
Pakistan Children are at a higher risk during COVID-19 because of interruption to during this pandemic. online, 2020 Jul 19]. J
supply food services. Moreover, undernourished children tend to have a Pediatr Nurs. 2020;S0882-
weaker immune system and hence, rendered more susceptible to the viral 5963(20)30499-1.
disease, with lesser chances of survival. UNICEF recommends promoting safe doi:10.1016/j.pedn.2020.06.
breastfeeding and providing complementary foods to children. 016
Guideline, 19-Jul-20 The Turkish Turk Pediatri Review Neonates are particularly susceptible to SARS-CoV-2. In the context of the This proposal from Erdeve Ö, Çetinkaya M, Baş
neonatal ICU, Neonatal Society Arsivi COVID-19 pandemic, the Turkish Neonatal Society proposed this protocol Turkey presents AY, et al. The Turkish
newborn, proposal for the with the evidence available at the time of preparation to handle neonates evidence-based Neonatal Society proposal
Turkey management of with SARS-CoV-2 infections and outbreaks in neonatal intensive care units recommendations for for the management of
COVID-19 in the (NICUs). This proposal presents recommendations on 1) COVID-19 in management and COVID-19 in the neonatal
neonatal pregnancy, including delivery room management, neonatal transport, NICU treatment of the intensive care unit. Turk
intensive care management; 2) COVID-19 in the newborn, including breastfeeding 3) neonatal cases during Pediatri Ars. 2020;55(2):86-
unit treatment; 4) discharge criteria; 5) procedures for handling bodies of the COVID-19 92. Published 2020 Jun 19.
deceased suspected or confirmed patients and autopsy. The authors pandemic. doi:10.14744/TurkPediatriA
believed this could be valuable for all countries. rs.2020.43788
12
Pregnancy, 18-Jul-20 Maternal and BMC Protocol The authors share a protocol for a systematic review seeking to summarize The authors outline Thomas B, Pallivalapila A, El
neonate, perinatal Systematic available literature on the following: clinical characteristics of COVID-19 in their protocol for a Kassem W, et al. Maternal
breastfeeding, outcomes and Reviews the maternal and perinatal populations, maternal and perinatal outcome systematic review that and perinatal outcomes and
clinical pharmacological measures being reported, and therapeutic interventions and safety of will be the first to pharmacological
characteristics, management of pharmacological therapies for COVID-19 during the antenatal, perinatal, and address therapeutic management of Covid-19
management, Covid-19 postnatal periods and during breastfeeding. management and safety infection in pregnancy: a
pharmacologica infection in of medicines to treat systematic review protocol
l treatment pregnancy: a COVID-19 during [published online 2020 Jul
systematic pregnancy and 18]. Syst Rev. 2020;9(1):161.
review protocol breastfeeding. doi:10.1186/s13643-020-
01418-2
Maternal 18-Jul-20 A pandemic International Clinical Article In order to evaluate the clinical course and effect of COVID-19 on pregnant This prospective cohort Sahin D, Tanacan A, Erol SA,
outcome, center's Journal of women, the authors conducted a prospective cohort study in Turkey on study from Turkey on et al. A pandemic center's
neonatal experience of Gynaecology pregnant women with confirmed or suspected SARS-CoV-2 infection who pregnant women with experience of managing
outcomes, managing and Obstetrics were admitted to the Ministry of Health Ankara City Hospital between confirmed or suspected pregnant women with
obstetric pregnant women March 11th and June 11th, 2020. Of 100 suspected pregnant women, 29 had SARS-CoV-2 infection COVID-19 infection in
outcomes, with COVID-19 confirmed SARS-CoV-2 infection. 8 of the remaining 71 cases had clinical shows that the clinical Turkey: A prospective
pregnancy, infection in findings highly suspicious for COVID-19. 10 (34.5%) of the confirmed cases course of COVID-19 cohort study [published
Turkey Turkey: A had co-morbidities. Cough (58.6%) and myalgia (51.7%) were the leading during pregnancy online, 2020 Jul 18]. Int J
prospective symptoms. 25 (86.2%) cases had mild COVID-19 disease. COVID-19 therapy appears to be mild. Gynaecol Obstet.
cohort study was given to 10 (34.5%) patients. There were no admissions to the ICU. doi:10.1002/ijgo.13318
[Free Access to Pregnancy complications were present in 7 (24.1%) patients. None of the
Abstract only] neonates were positive for SARS-CoV-2. Samples of breastmilk were also
negative for SARS-CoV-2. The authors stated that the clinical course of
COVID 19 during pregnancy appears to be mild in the present study.
Vertical 17-Jul-20 What are Clinical and Editorial The author summarizes recent data on potential transmission and risks of The author concludes Choi, Soo Han. What are
transmission, considerations Experimental COVID-19 infection in neonates. SARS-CoV-2 transmission to neonates is that viral transmission considerations for neonates
neonate, for neonates at Pediatrics thought to occur primarily through respiratory droplets during the postnatal of SARS-CoV-2 to at risk for COVID-19?
obstetric risk for COVID- period when neonates are exposed to mothers, caregivers, visitors, or neonates likely occurs [published online 2020 July
outcomes, 19? healthcare personnel with COVID-19. A recent WHO report noted that, of after birth, and most 17]. Clin Exp Pediatr. 2020
breastfeeding 115 mother–infant pairs from 17 studies in which the mother had confirmed professional societies doi.org/10.3345/cep.2020.0
COVID-19, 13 infants had COVID-19. Of the 20 whose breastmilk was tested report that the benefits 1074
for SARS-CoV-2 RNA particles by RT-PCR, 18 were negative and 2 were of breastfeeding
positive; one mother’s infant was not infected with COVID-19 (mix-fed), outweigh risks of
while the other was infected (feeding modality not reported). The CDC, transmission via
WHO, and American Academy of Pediatrics suggest that the benefits of breastmilk. Maternal
breastfeeding appear to outweigh the potential risks of viral transmission infection may pose a
from mother to infant. Of 262 women who gave birth in another study, 66 risk to neonates due to
(25%) did so preterm: 32 (48%) due to maternal COVID-19, 9 (14%) due to the rates of preterm
fetal compromise, and 12 (18%) due to other obstetric conditions. Three birth and fetal
neonates were stillborn and two died in the neonatal period; neither of the compromise.
neonatal deaths was attributed to SARS-CoV-2. Current evidence is
inconclusive about transplacental viral transmission.
13
Pregnancy, 13-Jul-20 Management of Clinical and Case Report The authors report on the first case of an infant born to a mother with This case describes the Lee, E.K., Kim, W.D., Lee,
transmission, the first Experimental confirmed COVID-19 in South Korea and describe the diagnosis, process for management of the D.W. and Lee, S.A.,
isolation, newborn Pediatrics delivery, and management of the newborn. The obstetrician performed a C- delivery of a newborn Management of the first
testing, South delivered by a section delivery and all medical staff wore PPE including gown, gloves, to a mother with newborn delivered by a
Korea mother with medical mask, and face shields for eye and face protection. The obstetrician COVID-19 in South mother with COVID-19 in
COVID-19 in used a powered air purifying respirator for respiratory protection. Remaining Korea, in which there South Korea. Clinical and
South Korea inpatients were discharged or transferred to other hospitals and the patient was no evidence of experimental pediatrics.
was asked not to breast-feed or stay with her baby. After delivery the intra-uterine 2020.
neonate was admitted to the NICU and isolated in a negative pressure transmission.
isolation room. Neonatal specimens were collected of the upper respiratory
tract (nasopharyngeal and oropharyngeal), gastric lavage fluid, blood, skin,
urine, and stool on arrival to the NICU. The mother’s placenta, cord blood,
and amniotic fluid were also collected and all ten specimens were tested via
RT-PCR and negative for SARS-CoV-2. Neonatal nasopharyngeal and
oropharyngeal tests were repeated after 48 hrs and confirmed negative. The
newborn was released from isolation but the mother remained isolated
during her active infection.
Breastfeeding, 12-Jul-20 Dietary Nutrition Review article Optimal nutrition can improve well-being and might mitigate the risk and This review summarizes de Faria Coelho-Ravagnani
food, hygiene, Recommendatio Reviews morbidity associated with COVID-19. This narrative review was carried out recent scientific C, Corgosinho FC, Sanches
supplementatio ns During the from December 2019 - April 2020, and 48 documents were retrieved. The literature and existing FFZ, Prado CMM, Laviano A,
n COVID-19 goal was to review guidelines on what nutritional advice is being offered for recommendations from Mota JF. Dietary
Pandemic individuals in quarantine during the COVID-19 pandemic. The majority of national and recommendations during
documents encouraged the consumption of fruits, vegetables, and whole- international nutrition the COVID-19 pandemic
grain foods. 31% of the guidelines highlighted the importance of minerals agencies on an optimal [published online, 2020 Jul
and vitamins such as zinc and vitamins A, C, and D to maintain a well- diet, vitamin and 12]. Nutr Rev.
functioning immune system. Dietary supplementation has not been linked to mineral 2020;nuaa067.
COVID-19 prevention. However, supplementation with vitamins C and D, as supplementation, and doi:10.1093/nutrit/nuaa067
well as with zinc and selenium, was highlighted as potentially beneficial for good hygiene practices
individuals with, or at risk of, respiratory viral infections or for those in for food preparation
whom nutrient deficiency is detected. There was no convincing evidence during the COVID-19
that food or food packaging is associated with the transmission of COVID-19, pandemic.
but good hygiene practices for handling and preparing foods were
recommended. 6 of 13 documents included in the review addressed
breastfeeding and suggested no changes in recommendations, even in
women diagnosed with COVID-19. The findings can be used to help dietitians
and healthcare professionals better address dietary recommendations
during the COVID-19 pandemic.
Vertical 10-Jul-20 In−Utero medRxiv Preprint In this prospective multicenter study, 31 SARS-CoV-2 positive pregnant This authors first Fenizia C, Biasin M, Cetin I,
transmission, Mother−To−Chil (not peer- women were enrolled from three hospitals of Lombardy, Italy between reported that SARS- et al. IN−UTERO
viral detection, d SARS−CoV−2 reviewed) March 9 and April 14, 2020. Real-time PCR was performed to detect the CoV-2 is found in the MOTHER−TO−CHILD
immune Transmission: virus and specific anti-SARS-CoV-2 antibodies on pregnant women and their vagina mucosa of a SARS−CoV−2
response, milk, viral detection fetuses. The authors reported for the first time that SARS-CoV-2 was found pregnant woman, at- TRANSMISSION: viral
Italy and fetal in the vagina mucosa of a pregnant woman, at-term placentae, the umbilical term placentae, the detection and fetal immune
immune cord blood, and in one milk specimen. Furthermore, they reported the umbilical cord blood, response [published online
response presence of specific anti-SARS-CoV-2 antibodies in the umbilical cord blood and in one milk 2020 Jul 10]. medRxiv.
of pregnant women, as well as in milk specimens. Finally, they observed that specimen. They also doi:10.1101/2020.07.09.201
a specific inflammatory response is triggered by SARS−CoV−2 infection in described the 49591
14
pregnant women at both systemic and placental levels and in umbilical cord inflammatory response
blood plasma. The findings in the study supported the hypothesis that triggered by SARS-CoV-
in−utero vertical transmission is possible in SARS−CoV−2 positive pregnant 2 infection in pregnant
women. women at both
systemic and placental
levels.
Pregnancy, 10-Jul-20 COVID-19 as a Sexual and Commentary The concept of obstetric violence has highlighted the commonly experienced The authors describe Sadler M, Leiva G, Olza I.
obstetric risk factor for Reproductive issues of abuse and disrespect toward laboring women, and the authors concern that certain COVID-19 as a risk factor for
violence, obstetric Health express concern about the quality of maternity care, childbirth rights, and interventions being obstetric violence
human rights, violence Matters standards of care receding during the COVID-19 pandemic. They argue that used during labor and [published online 2020 Jul
mother-infant some of the restrictions and interventions being implemented due to the delivery due to the 10]. Sex Reprod Health
separation, COVID-19 outbreak are not necessary, not based on scientific evidence, are COVID-19 pandemic are Matters. 2020.
breastfeeding, disrespecting human dignity and are not proportionate to achieve the not evidence-based, will doi:10.1080/26410397.2020
visitor objective of limiting the spread of the virus. These include unnecessary inflict harm on the .1785379
restrictions interventions done without medical indications (such as caesareans or mother and infant, and
instrumental deliveries), prohibition of companionship during labor, will cause a regression
immediate separation and isolation from the newborn, and the prevention in women's human
of breastfeeding. The authors describe the potential harms from each of rights during childbirth.
these interventions and express fear that due to the COVID-19 pandemic
there will be regression in the achievement of positive birth experiences for
women, newborns and families around the world.
Pregnancy, 10-Jul-20 Multi-center Acta Original Article This multicenter descriptive study in Spain sought to describe the clinical This study found no Marín Gabriel MA,
neonate, Spanish Study Paediatrica features of mothers infected with COVID‐19, examine any potential vertical vertical transmission or Cuadrado I, Álvarez
vertical Found No mother to newborn transmission, and assess the efficacy of discharge transmission of COVID- Fernández B, et al. Multi-
transmission, Incidences of recommendations in preventing transmission during the first month of the 19 from mother to centre Spanish study found
Spain Viral newborn's life. The study reviewed records from 16 Spanish hospitals of 42 infant in the first month no incidences of viral
Transmission in pregnant women diagnosed with COVID-19 from March 13-29, 2020, in their of the infant's life. transmission in infants born
Infants Born to 3rd trimester. They and their newborn infants were monitored until the There was a low to mothers with COVID-19
Mothers With infant was one month old. Over half (52.4%) of the women had a vaginal exclusive breastfeeding [published online 2020 Jul
COVID-19 delivery. The initial clinical symptoms were coughing (66.6%) and fever rate at discharge, 10]. Acta Paediatr.
(59.5%). One mother died due to thrombo‐embolic events. 37 newborn thought to be due to 2020;10.1111/apa.15474.
infants were admitted to the neonatal unit (88%) and 28 were then admitted the measures to avoid doi:10.1111/apa.15474
to intermediate care for organizational virus‐related reasons. No infants died transmission.
and no vertical transmission was detected during hospitalization or follow
up. Only six were exclusively breastfed at discharge. There was no evidence
of COVID‐19 transmission in any of the infants born to COVID‐19 mothers,
and the post-discharge advice seemed effective. The measures to avoid
transmission appeared to reduce exclusive breastfeeding at discharge.
Breast milk, 10-Jul-20 The Impact of Applied Review article This study reviewed primary research articles to characterize the effect of According to the Pitino MA, O'Connor DL,
pasteurization, Thermal Physiology, common pasteurization techniques on viruses in human milk (HM) and non- findings in this review, McGeer AJ, Unger S. The
viral load, viral Pasteurization Nutrition, and HM matrices. 109 studies were included. Pasteurization of HM at a minimum the standard impact of thermal
inactivation on Viral Load and Metabolism temperature of 56ºC-60ºC is effective for reducing detectable live virus. In pasteurization pasteurization on viral load
Detectable Live cell culture media or plasma, coronaviruses (e.g., SARS-CoV, SARS-CoV-2, procedures used at milk and detectable live viruses
Viruses in MERS-CoV) are highly susceptible to heating at ≥56ºC. Although banks for human milks in human milk and other
Human Milk and pasteurization parameters and matrices reported vary, all viruses studied, may be sufficient to matrices: A rapid review
Other Matrices: except parvoviruses, were susceptible to thermal killing. Future research inactivate non-heat [published online 2020 Jul
A Rapid Review important for the study of novel viruses should standardize pasteurization resistant viruses, 10]. Appl Physiol Nutr
15
protocols and should test inactivation in HM. In all matrices, including HM, including coronaviruses, Metab. 2020.
pasteurization at 62.5ºC was generally sufficient to reduce the surviving viral whether present via doi:10.1139/apnm-2020-
load by several logs or to below the limit of detection. Holder pasteurization vertical transmission or 0388
of HM (heating to 62.5ºC for 30 min), the standard pasteurization procedure as a contaminant.
conducted at milk banks, should be sufficient to inactivate non-heat
resistant viruses, including coronaviruses, if present.
Breastfeeding, 9-Jul-20 Negative Breastfeeding Original Research This is an observational prospective study that included pregnant women In this study, colostrum Marín Gabriel MÁ, Malalana
colostrum, Transmission of Medicine who tested positive for SARS-CoV-2 by PCR at time childbirth and who was not found to Martínez AM, Marín
hand SARS-CoV-2 to wanted to breastfeed their newborns. Colostrum samples were obtained contain SARS-CoV-2 Martínez ME, et al. Negative
expression Hand-Expressed from seven mothers by manual self-extraction in the first hours post- following hand Transmission of SARS-CoV-2
Colostrum From delivery. To collect the samples, the mothers wore surgical masks, washed expression by COVID- to Hand-Expressed
SARS-CoV-2- their hands with an 85% alcohol-based gel, and washed their breast with positive mothers, Colostrum from SARS-CoV-
Positive Mothers gauze that was saturated with soap and water. SARS-CoV-2 was not contributing to the 2-Positive Mothers
[Free Access to detected in any of the colostrum samples obtained in our study. As breast growing body of [published online 2020 Jul
Abstract only] milk was not a source of SARS-CoV-2 transmission in this study, hand literature regarding the 9]. Breastfeed Med. 2020.
https://www.lieb expression (assuring that a mask is used and that appropriate hygienic safety of feeding doi:10.1089/bfm.2020.0183
ertpub.com/doi/ measures are used for the hands and the breast), when direct breastfeeding newborns of COVID-
abs/10.1089/bf is not possible, appears to be a safe way of feeding newborns of mothers positive mothers with
m.2020.0183 with COVID-19. breast milk.
Breast milk, 9-Jul-20 Holder Canadian Original Research Pasteurized donor human milk is the standard of care for nutrition in very Holder pasteurization Unger S, Christie-Holmes N,
donor human Pasteurization of Medical low birth weight infants in hospital. The aim of this study was to determine if was sufficient to Guvenc F, et al. Holder
milk, Donated Human Association Holder pasteurization (62.5°C for 30 min) would be sufficient to inactivate inactivate SARS-CoV-2 pasteurization of donated
pasteurization, Milk Is Effective Journal SARS-CoV-2 in donated human milk samples. Frozen milk samples from ten in ten donor human human milk is effective in
transmission in Inactivating (CMAJ) donors were inoculated with SARS-CoV-2 at 1 x 10^7 TCID50/mL (50% of the milk samples inoculated inactivating SARS-CoV-2
SARS-CoV-2 tissue culture infectivity dose per mL). The samples were then pasteurized with a high titer of the [published online, 2020 Jul
using the Holder method or held at room temperature for 30 minutes virus. This is the first 9]. CMAJ.
(unpasteurized). Comparative controls of milk samples from the same report of the effect of doi:10.1503/cmaj.201309
donors without addition of the virus (pasteurized and unpasteurized) were pasteurization on
used. Cytopathic activity was undetected in all pasteurized SARS-CoV-2 milk coronaviruses in human
samples. In the unpasteurized SARS-CoV-2–spiked milk samples, the milk.
infectious viral titer was reduced by about 101. The authors concluded that
pasteurization of human milk by the Holder method inactivates SARS-CoV-2.
Thus, in the event that donated human milk contains SARS-CoV-2, this
method renders milk safe for consumption and handling.
Vertical 8-Jul-20 Vertical Clinical Letter to the The authors performed a retrospective case series of all pregnant patients The authors report no Masmejan S, Pomar L, Favre
transmission, Transmission Microbiology Editor with SARS-CoV2 infection during pregnancy admitted to the University cases of vertical G, et al. Vertical
pregnancy, and Materno- and Infection Hospital in Lausanne, Switzerland for delivery between April 1 to May 6, transmission and no transmission and materno-
Lausanne, Fetal Outcomes 2020. Thirteen patients with SARS-CoV-2 infection during pregnancy were detection of the fetal outcomes in 13
Switzerland in 13 Patients identified (12 with positive nasopharyngeal PCR and 1 symptomatic with presence of SARS-CoV2 patients with COVID-19
With COVID-19 positive serology but 3 negative PCRs). None of the placenta, cord blood nor in placental swabs. [published online, 2020 Jul
neonate nasopharyngeal swabs were positive for SARS-CoV-2. Maternal 8]. Clin Microbiol Infect.
fecal samples were not tested in this series, although symptomatic patients, 2020;S1198-743X(20)30381-
especially those with digestive symptoms, excrete the virus in their stool. 5.
Out of 13 patients, one patient had a critical course of COVID-19, and she doi:10.1016/j.cmi.2020.06.0
required 8 days of mechanical ventilation. Regarding the neonates, rooming- 35
in (85%) and breastfeeding (69%) were encouraged. The median age at
16
discharge (3 days) and the rate of hospitalization (15%) indicate excellent
neonatal outcomes.
Breast feeding, 7-Jul-20 Breast Feeding in Journal of Review Article Currently, there is no universal consensus on managing the issue of The author summarizes Hethyshi R. Breast Feeding
guidelines, Suspected or Obstetrics & breastfeeding with rooming-in for neonates of women with suspected or the available evidence in Suspected or Confirmed
neonate, Confirmed Cases Gynecology of confirmed COVID-19. The published literature continues to evolve with on breastfeeding in Cases of COVID 19-a New
vertical of COVID 19-a India contradictory guidelines from various authorities across the world. In this cases of suspected or Perspective. [published
transmission New Perspective review, the author analyzes the available evidence on breastfeeding in confirmed COVID-19 online, 2020 Jul 7]. J Obstet
women with suspected or confirmed COVID-19. The article discusses the and recommends Gynaecol India.
current data on vertical transmission and transmission through breast milk mother-neonate doi:10.1007/s13224-020-
of SARS-CoV-2 as well as on neonatal COVID-19. The author concludes that rooming-in with direct 01336-2
the benefits of mother-neonate rooming-in and direct breastfeeding, breastfeeding based on
including health benefits and financial implications, outweigh the risk in this review of the
cases of suspected or confirmed SARS-COV-2 infection as of now. Yet future current literature.
research with larger sample size is warranted to further understanding of
vertical transmission, effects of the SARS-COV-2 on early pregnancy, and on
transfer of antiviral antibodies through breast milk.
Breastfeeding, 6-Jul-20 Setting Realistic Acta Commentary There is lack of sufficient data and consensus regarding mother-infant The authors argue that Mosalli R, Paes B. Setting
nutrition, Goals for Paediatrica contact in the setting of mothers with suspected or confirmed COVID-19 a shared decision- realistic goals for feeding
mother-infant Feeding Infants infection, with different public health agencies and professional societies making approach for infants when their mothers
separation, When Their globally issuing varying recommendations, particularly around separating a breastfeeding should be have suspected or
shared decision Mothers Have mother and infant. Regardless of the approach taken to separation, full used when mothers confirmed COVID-19
making Suspected or precautions should be adopted to avoid respiratory transmission of the virus have suspected or [published online 2020 Jul
Confirmed from mother to infant. The authors describe options to be considered for confirmed COVID-19 6]. Acta Paediatr. 2020.
COVID-19 feeding in a variety of scenarios and advocate for shared-decision making in infection, ensuring that doi:10.1111/apa.15459
all scenarios. parents fully
understand current
evidence, availability of
breastfeeding support,
and other relevant
resources. In lower-
resource settings,
nutrition should be
optimized in the best
interest of both mother
and child.
Mental health. 3-Jul-20 Mental Health International Brief Pregnancy and early parenthood are characterized by intense emotions and Pregnant and Ceulemans M, Hompes T,
pregnancy, Status of Journal of Communication a high vulnerability to emotional problems. Pregnant and breastfeeding breastfeeding women Foulon V. Mental health
breastfeeding, Pregnant and Gynecology & women now also have to face the COVID-19 pandemic. The authors argue in Belgium have higher status of pregnant and
Belgium Breastfeeding Obstetrics that research aimed assessing the impact of COVID-19 on maternal-fetal levels of depression and breastfeeding women
Women During outcomes should not neglect perinatal mental health. They conducted an anxiety during the during the COVID-19
the COVID-19 online survey in Belgium to investigate maternal mental health status after a COVID-19 pandemic pandemic: A call for action
Pandemic: A Call few weeks of lockdown (n=5866 women, 2421 pregnant and 3445 compared to before the [published online, 2020 Jul
for Action breastfeeding). They found that almost half of the surveyed women current crisis. 3]. Int J Gynaecol Obstet.
experienced depressive or anxious symptoms during the lockdown period. Obstetricians should be doi:10.1002/ijgo.13295
The prevalence of self-reported major depressive symptoms in pregnancy aware that the
(25.3%) and post-partum (23.6%) were explicitly higher when compared to pandemic and
before the pandemic. The authors conclude that routine depression and associated isolation
17
anxiety screening should be considered in obstetrical settings during the measures may place an
COVID-19 pandemic. additional burden on
the emotional wellbeing
of their patients.
Breast feeding, 1-Jul-20 The COVID-19 The Journal of Original Article Childbirth educators play a particularly important role in ensuring that The authors emphasize Spatz DL. The COVID-19
perinatal care, Pandemic: The Perinatal families receive appropriate evidence-based information about human milk the importance of Pandemic: The Role of
childbirth Role of Education and breastfeeding as a lifesaving medical intervention. In the current COVID- childbirth educators in Childbirth Educators in
Childbirth 19 pandemic, breastfeeding and the provision of human milk remains recommending Promoting and Protecting
Educators in recommended by national and international organizations. breastfeeding during Breastfeeding. [published
Promoting and the COVID-19 online, 2020 Jul 1]. J Perinat
Protecting pandemic. Educ. 2020;29(3):120-122.
Breastfeeding doi:10.1891/J-PE-D-20-
00024
[Free Access to
Abstract only]
Pregnancy, 1-Jul-20 Clinical European Review This systematic literature review evaluated the clinical manifestations and This review adds to the Yoon SH, Kang JM, Ahn JG.
neonate, outcomes of 201 Review for outcomes of neonates born to women with COVID-19 infection during body of literature Clinical outcomes of 201
vertical neonates born to Medical and pregnancy. The review included 16 case series and 12 case reports regarding clinical neonates born to mothers
transmission, mothers with Pharmacologi describing a total of 223 pregnant women and 201 infants. 4 newborns born outcomes of neonates with COVID-19: a systematic
clinical COVID-19: a cal Sciences to mothers affected by COVID-19 had laboratory-confirmed SARS-CoV-2 born to women with review. Eur Rev Med
characteristics, systematic infection within 48 hours after birth. RT-PCR tests of the breast milk, COVID-19 infection Pharmacol Sci.
Seoul, South review placenta, amniotic fluid, cord blood and maternal vaginal secretions were all during pregnancy, 2020;24(14):7804-7815.
Korea negative for SARS-CoV-2 in the reported cases. Fetal death was reported in finding that COVID-19 doi:10.26355/eurrev_20200
two cases, and 48 of 185 newborns (25.9%) were born prematurely. Infants during pregnancy rarely 7_22285
born small for gestational age and low birth weight (<2,500 g) accounted for affects neonatal
8.3% and 15.6% of reported cases, respectively. Birth asphyxia and mortality or manifests
respiratory distress syndrome were observed in 1.8% and 6.4% of neonates, in vertical transmission
respectively. There was one neonatal death due to intractable gastric but can be associated
bleeding among the SARS-CoV-2-negative infants. Current evidence suggests with adverse neonatal
that COVID-19 during pregnancy rarely affects fetal and neonatal mortality morbidities.
but can be associated with adverse neonatal morbidities. Vertical
transmission has not been observed in the majority of the reported cases.
Pneumonia, 1-Jul-20 Coronavirus American Original Research The authors sought to evaluate the clinical characteristics and outcomes of In this article, the Yan J, Guo J, Fan C, et al.
pregnancy, Disease 2019 in Journal of COVID-19 in pregnancy. They retrospectively reviewed the medical records authors present clinical Coronavirus disease 2019 in
preterm birth, Pregnant Obstetrics and for 116 pregnant women with COVID-19 who were admitted to 25 hospitals and laboratory findings pregnant women: a report
vertical Women: A Gynecology in China between 20 January- 24 March 2020. Eight cases (6.9%) of the largest case based on 116 cases.
transmission Report Based on experienced a severe pneumonia requiring ICU admission, but no maternal series of pregnant [published online, 2020 Jul].
116 Cases deaths occurred. One patient with severe pneumonia had a missed women with clinically or Am J Obstet Gynecol.
spontaneous abortion. Of 99 patients who delivered, 21 (21.2%) had laboratory-confirmed doi:10.1016/j.ajog.2020.04.
preterm birth before 37 weeks, including six with preterm premature COVID-19 to date 014
rupture of membranes. There was one case of severe neonatal asphyxia. Of (n=116). They found no
86 neonates tested for SARS-CoV-2, all had negative results. Paired amniotic evidence of vertical
fluid and cord blood samples from 10 neonates were used to test for SARS- transmission in
CoV-2; all had negative results. The authors concluded that SARS-CoV-2 neonates (n=86) and no
infection during pregnancy is not associated with an increased risk of evidence of SARS-CoV-2
spontaneous abortion and spontaneous preterm birth. They found no in breast milk samples
(n=12).
18
evidence of vertical transmission of SARS-CoV-2 when the infection occurs
during the third trimester of pregnancy.
Breastfeeding, 1-Jul-20 Virolactia in an Breastfeeding Case Report A 20-year-old asymptomatic pregnant woman presented for delivery at 39- In this report, the Bastug A, Hanifehnezhad A,
breast milk, Asymptomatic and Medicine week gestation in Turkey and was tested for SARSCoV-2 by RT-PCR due to a authors present a case Tayman C, et al. Virolactia in
transmission, Mother With recent exposure. She wore a surgical mask during normal vaginal delivery of of subclinical SARS- an Asymptomatic Mother
neonatal COVID-19 a 2,980g male infant. Her test result was positive, so mother and newborn CoV2 infection in a with COVID-19 [published
infection, were separated immediately after delivery and both were transferred to mother and her infant 2020 Jul 1]. Breastfeed
Turkey another hospital. The mother and infant were cared for in separate clinical after SARS-CoV-2 was Med.
units to avoid contact; the SARS-CoV-2 PCR test of a nasopharyngeal swab detected in colostrum doi:10.1089/bfm.2020.0161
from the infant on admission was negative. Expressed breast milk was given and breast milk. It
to the infant by health care professionals under strict precautions (hand remains unclear
hygiene, face mask, etc.). After the first lactation, a breast milk sample whether the infant's
tested positive for SARS-CoV-2. Feeding with expressed breast milk was first SARS-CoV-2 RT-PCR
discontinued and breast milk samples were tested for SARS-CoV2 for the test result was a false
next 2 consecutive days. Neonatal blood, stool, and nasopharyngeal samples negative, consistent
were also obtained for testing and were all positive for SARS-CoV-2. Neither with congenital or
the mother nor infant exhibited any symptoms, required any intervention, peripartum infection, or
and both were discharged five days after admission. whether the infant was
subsequently infected
through breast milk.
Breastfeeding, 30-Jun-20 SARS-CoV-2 in The Lancet Preprint (not Though identification of all potential infective vehicles for SARS-CoV-2 is The authors argue that Bernito E, Moro GE, De
human milk, Human Breast peer reviewed) important for disease prevention, possible transmission of SARS-CoV-2 via SARS-CoV-2 positive Renzi G, et al. SARS-CoV-2 in
breast milk, Milk and breastmilk remains largely unexplored. In this study, authors collected mothers do not expose Human Breast Milk and
newborn, swab Neonatal breastmilk from twelve SARS-CoV-2 positive mothers and analyzed samples their newborns to an Neonatal Outcome: A
test Outcome: A for viral RNA using RT PCR. Eleven of the twelve samples were negative for additional risk of Collaborative Study. The
Collaborative viral RNA. Eleven of the twelve newborns were exclusively breastfed in the infection by Lancet. Published 30 June
Study first month of life and closely monitored, and clinical outcome was breastfeeding. They 2020. doi:
uneventful. Four newborns tested positive for SARS-CoV-2 and were all state that mothers 10.2139/ssrn.3611974
detected in the first 48 hours of life after onset of maternal symptoms. The should breastfeed,
remaining eight infants were not positive and/or symptomatic in the first irrespective of swab
month of life. The clinical course of infected infants was uneventful, test results, considering
including the infant that received SARS-CoV-2 positive breastmilk. Study the immunological and
authors hypothesize that the SARS-CoV-2 positive breastmilk could be anti-infective properties
caused by viral shedding and/or lack of compliance to hygiene protocols. The of mother’s milk.
authors conclude that SARS-CoV-2 positive mothers pose no additional risk
to their infants by breastfeeding and that breastmilk, even when positive for
SARS-CoV-2, is not a vehicle of infection; however, mothers must follow
strict hygiene protocols to minimize infants’ risk of infection via other modes
of transmission.
Childbirth, 30-Jun-20 Childbirth, Revista da Review This article provides a comprehensive review of clinical recommendations in This review article Trapani Júnior A, Vanhoni
pregnancy, Puerperium and Associação Brazil regarding childbirth, postpartum, and abortion care during the COVID- provides clinical LR, Silveira SK, Marcolin AC.
postpartum, Abortion Care Médica 19 pandemic for suspected and confirmed cases of maternal COVID-19. The recommendations to Childbirth, Puerperium and
abortion care, Protocol During Brasileira authors review the risks and clinical characteristics of COVID-19 in pregnancy Brazilian obstetricians Abortion Care Protocol
Brazil the COVID-19 and provide recommendations for laboratory assessments, location and regarding childbirth, during the COVID-19
Pandemic timing of delivery, visitors, labor induction, operative delivery, fetal postpartum and Pandemic. Rev Bras Ginecol
assessment, anesthesia, intrauterine resuscitation, cord clamping, skin-to- abortion care during Obstet. doi:10.1055/s-
skin, breastfeeding, and medications. the pandemic. 0040-1713587
19
Bonding, 26-Jun-20 Promoting Acta Clinical overview Social distancing is the only option available during the COVID‐19 pandemic This paper examines Tscherning C, Sizun J, Kuhn
guidelines, Attachment Paediatrica until a vaccine is developed. However, this is having a major impact on the guidelines and P. Promoting attachment
separation, Between Parents human relationships and bonding between parents and neonates is a major clinical evidence and between parents and
neonates and Neonates concern. Separation during this health emergency could have lifelong explores how neonates despite the
Despite the consequences for offspring and there are even greater concerns if newborn transmission risks can COVID-19 pandemic
COVID-19 infants are sick or vulnerable and need intensive care. The authors look at be balanced with [published online, 2020 Jun
Pandemic how bonding can be safely supported and maintained without risking neonates’ needs for 26]. Acta Paediatr.
infecting neonates, by comparing the international guidelines and proposing early bonding and doi:10.1111/apa.15455
safe actions within those frameworks. nutrition, including skin-
to-skin contact and
breastfeeding.
Pregnancy, 25-Jun-20 Are Covid-19- Journal of Viewpoint In this viewpoint article, the author calls for further evaluation of obstetric Obstetric interventions Stanojević M. Are Covid-19-
obstetric positive Mothers Perinatal interventions with potential for overuse and unintended harm in the intended to save lives positive mothers dangerous
interventions, Dangerous for Medicine response to COVID-19, such as performance of C-sections. COVID-19 have the potential for for their term and well
evidence-based Their Term and infection in pregnant women resembles infection in the non-pregnant adult overuse and newborn babies? Is there an
medicine Well Newborn population, with evidence of low probability for adverse maternal or unintended harm (e.g. answer?. J Perinat Med.
Babies? Is There perinatal outcomes and likely no vertical transmission from mother to fetus. C-sections, use of infant 2020;48(5):441-445.
an Answer? The most controversial procedures in the care of COVID-19-suspected or - formula). Further doi:10.1515/jpm-2020-0186
positive asymptomatic women in labor are: mode of delivery, companion evidence will help
during birth and labor, cord clamping, skin-to-skin contact, breastfeeding, inform care regarding
and visits during a hospital stay. Interventions should be evidence-based and mode of delivery,
optimize outcomes for mothers, babies and families. presence of companion
during birth and labor,
cord clamping, skin-to-
skin contact, and
breastfeeding for
pregnant women with
COVID-19.
Neonate, 23-Jun-20 Care of The Journal of Review article The authors discuss how to care for a newborn of a mother with suspected The authors contend Shahbazi Sighaldeh S,
mother- Newborns Born Maternal- or confirmed COVID-19 using existing evidence. As of 16 April 2020, the that based on Ebrahimi Kalan M. Care of
newborn to Mothers With Fetal and authors reviewed articles and guidelines related to COVID-19 in the information available as newborns born to mothers
separation COVID-19 Neonatal reproductive health field, mother, and newborn health. The findings showed of 16 April 2020, with COVID-19 infection; a
Infection; A Medicine that the possibility of intra-uterine or perinatal transmission of COVID-19 is mother-newborn review of existing evidence
Review of still questionable and ambiguous. However, close contact of mother and separation is [published online 2020 Jun
Existing Evidence infant after birth can transmit the virus through droplets or micro-droplets. recommended for two 23]. J Matern Fetal Neonatal
Based on these findings, it is recommended to separate the newborn from weeks in the setting of Med. 2020;1-13.
the mother with suspected or confirmed COVID-19 infection for at least 2 suspected or confirmed doi:10.1080/14767058.2020
weeks. The mothers should be taught about breast milk expression skills, maternal COVID-19 .1777969
common breast problems, and principles of personal hygiene to protect the infection to prevent
infant against COVID-19 infection. possible transmission to
the newborn.
20
Breastfeeding, 21-Jun-20 Breastmilk and Clinical Commentary The American Academy of Pediatrics (AAP) provided initial guidance that Current evidence does Kimberlin DW, Puopolo KM.
neonatal COVID-19: What Infectious took the conservative stance of recommending that COVID-19 infected not clearly demonstrate Breastmilk and COVID-19:
infection, Do We Know? Diseases mothers be temporarily separated from their newborns immediately after that SARS-CoV-2 can be What Do We Know?
mother- delivery, and being fed expressed breast milk rather than directly transmitted through [published online 2020 Jun
newborn breastfeeding during the period of high maternal infectivity. Nutritional and breastmilk. Until there 21]. Clin Infect Dis.
separation immunological benefits of breastfeeding are well established, with is clear evidence the doi:10.1093/cid/ciaa800
breastfeeding recommended by the AAP except in the case of a few breast milk is a source
infectious diseases. Initial reports did not detect SARS-CoV-2 in breastmilk; of SARS-CoV-2 infection
there are now case reports of the virus being found in breastmilk, but the and that acquiring
question of contamination by respiratory secretions remains. With the infection via breast milk
currently available evidence, it is recommended that a mother who becomes harms the infant, the
infected with SARS-CoV-2 continue to breastfeed her infant, although the proven short-term and
milk could be given by a non-infected caregiver if possible. Future studies long-term benefits of
are needed on presence of live virus in breastmilk, and on development of breast milk feeding
IgG or IgA antibodies against SARS-CoV-2. should be the primary
consideration in parent
counsel.
Breast milk, 20-Jun-20 SARS-CoV-2 in medRxiv Preprint (not As the COVID-19 pandemic evolves, human milk banks worldwide continue The findings Walker GJ, Clifford V,
donor milk, human milk is peer reviewed) to provide donor human milk to vulnerable infants who lack access to the demonstrate that SARS- Bansal V, et al. SARS-CoV-2
pasteurized, inactivated by mother’s milk. Under these circumstances, ensuring the safety of donor CoV-2 can be effectively in human milk is inactivated
cold storage Holder human milk is paramount, as the risk of vertical transmission of SARS-CoV-2 inactivated by Holder by Holder pasteurization
pasteurization is not well understood. The authors investigate the inactivation of SARS-CoV- pasteurization and but not cold
but not cold 2 in human milk by pasteurization and the stability of SARS-CoV-2 in confirm that storage. medRxiv. doi:10.11
storage human milk under cold storage (freezing or refrigeration). Following heating existing milk bank 01/2020.06.18.20134395
to 63°C or 56°C for 30 minutes, SARS-CoV-2 replication competent (i.e. live) processes will
virus was undetected in both human milk and the control medium. Cold effectively mitigate the
storage of SARS-CoV-2 in human milk (either at 4°C or - 30°C) did not risk of transmission
significantly impact infectious viral load over 48 hours. of SARS-COV-2 to
vulnerable infants
through pasteurized
donor human milk.
Receptor 20-Jun-20 Female bioRxiv Pre-print (not SARS-CoV2 binds to the angiotensin-converting enzyme 2 (ACE2) receptor on The epithelia of female Goad J, Rudolph J, Rajkovic
expression, Reproductive peer-reviewed) host cells, and entry of the virus into the host cell is additionally mediated by reproductive organs A. Female reproductive
tissue Tract Has Low the protease TMPRSS2. In the absence of TMPRSS2, SARS-CoV2 is known to (uterus, myometrium, tract has low concentration
susceptibility, Concentration of use cathepsins CTSB and CTSL as an alternate for entry. The authors ovary, fallopian tube, of SARS-CoV2 receptors.
ACE2, female SARS-CoV2 analyzed single-cell sequencing datasets from uterine, ovarian, fallopian breast) lack the co- Preprint. bioRxiv.
reproductive Receptors tube, and breast epithelial tissue to investigate the presence of location of the ACE2 2020;2020.06.20.163097.
organs, [upload from link ACE2/TMPRSS2 receptor expression. They did not detect significant receptor with proteases Published 2020 Jun 22.
cathepsins might take a long expression of either ACE2 or TMPRSS2 in any of the female reproductive known to facilitate doi:10.1101/2020.06.20.163
time (on 3 July organs assessed. Furthermore, none of the cell types showed co-expression SARS-CoV-2 viral entry 097
2020)] of ACE2 with proteases TMPRSS2, Cathepsin B (CTSB), and Cathepsin L into host cells. They are
(CTSL). These results suggest that myometrium, uterus, ovaries, fallopian therefore not likely
tube, and breast are unlikely to be susceptible to infection by SARS-CoV2. susceptible to SARS-
CoV-2 infection.
21
Obstetric 19-Jun-20 COVID-19 as a Sexual and Commentary This commentary expresses concern that COVID-19 related restrictions and This commentary Sadler M, Leiva G, Olza I.
violence, Risk Factor for Reproductive interventions during labor, delivery and the immediate postpartum period describes practices that COVID-19 as a risk factor for
delivery Obstetric Health may not be medically necessary and may instead constitute obstetric have been undertaken obstetric violence
method, Violence Matters violence. Specific concerns are raised about interventions during labor during childbirth due to [published online 2020 Jun
mother- without medical indication, such as Cesarean sections, mother-newborn the COVID-19 pandemic 19]. Sex Reprod Health
newborn separation following delivery, prohibition of companionship during labor, and expresses concern Matters. 2020;1-4.
separation, and prevention of breastfeeding. The commentary describes that these that these practices are doi:10.1080/26410397.2020
breastfeeding practices are at odds with WHO guidelines issued for COVID-19 management not evidence-based but .1785379
and can have long-term detrimental effects but have been undertaken in rather represent
many countries and articulates that these disrespect the patient's dignity obstetric violence in
and deny women's rights during childbirth. disrespecting women's
rights during childbirth.
Breastfeeding, 19-Jun-20 The impact of medRxiv Preprint (not The COVID-19 New Mum Study is recording maternal experiences and infant Lockdown has had an Vazquez-Vazquez A, Dib S,
infant feeding, the Covid-19 peer-reviewed) feeding during the period of UK lockdown via an anonymous online survey impact on maternal Rougeaux E, et al. The
maternal lockdown on the completed by women living in the UK aged ≥18 years with an infant ≤12 experiences, resulting in impact of the Covid-19
mental health, experiences and months of age. Between May 27 and June 3, 2020, the first week of the distress for many lockdown on the
lockdown, UK feeding practices survey, 1365 women responded (94% white, 95% married/with partner). women as well as experiences and feeding
of new mothers 1049 (77%) delivered before lockdown (BL) and 316 (23%) during lockdown decreased feeding practices of new mothers in
in the UK: (DL). Delivery mode, skin-to-skin contact and breastfeeding initiation did not support. Survey the UK: Preliminary data
Preliminary data differ between groups. DL women had shorter hospital stays (p<0.001) and participants are from the COVID-19 New
from the COVID- 39% reported changes to their birth plan. Reflecting younger infant age, 59% currently not Mum Study [published
19 New Mum of DL infants were exclusively breast-fed or mixed fed versus 39% of BL representative of the online 2020 Jun 19].
Study (p<0.05). 13% reported a change in feeding, often related to lack of population; notably, medRxiv.
breastfeeding support, and 45% of DL women reported insufficient support groups at greater risk doi:10.1101/2020.06.17.201
with feeding. Among BL women, 57% and 69% reported decreased feeding are under-represented. 33868
support and childcare, respectively. 40% BL/45% DL women reported
insufficient support with their own health, 8%/9% contacted a mental health
professional and 11% reported their mental health was affected.
Neonates, 18-Jun-20 COVID-19 in Pathogens Review article This review includes 37 studies from MEDLINE and EMBASE databases, Pregnant women with Trippella G, Ciarcià M,
pregnancy Pregnant involving 275 pregnant women with COVID-19 and 248 neonates. The COVID-19 mostly Ferrari M, et al. COVID-19 in
Women and majority of pregnant women presented with mild to moderate symptoms, presented with mild or Pregnant Women and
Neonates: A only 10 were admitted in the ICU, and one died. Two stillbirths were moderate symptoms. Neonates: A Systematic
Systematic reported and the incidence of prematurity was 28%. 16 neonates were The outcome of Review of the Literature
Review of the tested positive for SARS-CoV-2 by RT-PCR, and 9 of them were born from neonates born from with Quality Assessment of
Literature With mothers infected during pregnancy. Neonatal outcomes were generally infected mothers the Studies. Pathogens.
Quality favorable, although neonates at risk should be closely monitored. RT-PCR for appeared mostly Published 2020 Jun 18.
Assessment of SARS-CoV-2 yielded negative results on amniotic fluid, vaginal/cervical fluids, favorable. doi:10.3390/pathogens9060
the Studies placenta tissue, and breast milk samples. SARS-CoV-2 infection in pregnant 485
women appeared associated with mild or moderate disease in most cases,
with a low morbidity and mortality rate.
Antibodies, Mat 18-Jun-20 Antibodies in the Emerging Letter A 33-year-old primiparous woman (38 weeks 2 days of gestation with Breastmilk was found Dong Y, Chi X, Huang H, et
ernal, Breastmil Breast Milk of a Microbes & irregular lower abdominal pain with vaginal fluid for 6 hours) with cough and negative for SARS-CoV- al. Antibodies in the
k Maternal Infections chest tightness was admitted to hospital for childbirth on February 26, 2020. 2. The IgG and IgA breast milk of a maternal
Woman With Throat swabs tested positive for SARS‐CoV‐2 at admission, but there was antibodies were woman with COVID-
COVID-19 neither antiviral nor antibiotic treatment for the patient due to the detected in breast milk, 19. Emerging Microbes &
pregnancy. After delivery, the woman was positive for SARS-CoV-2 tested in indicating that Infections [published online
throat swabs but tested negative in other body fluids, and she had IgG and breastfeeding might 2020 Jun
22
IgA detected in breast milk. The neonate had a negative result for SARS-CoV- have the potential 18]. doi: 10.1080/22221751.
2 RNA at the birth and her IgG antibody to SARS-CoV-2 was observed only benefit to the 2020.1780952
within one and a half month after birth, indicating the placenta transmission neonates.
of COVID antibody.
Infant, cardiac 18-Jun-20 COVID-19 Pediatric Case Report A full-term, formula-fed 38-day-old male presenting with fever, rhinitis, and This case report Del Barba P, Canarutto D,
involvement, Cardiac Pulmonology modest hypo-reactivity was admitted on March 27, 2020. Nasal and contributes to literature Sala E, et al. COVID-19
myocardial Involvement in a pharyngeal swabs tested positive for SARS‐CoV‐2. An increase in troponin T on cardiac involvement cardiac involvement in a 38-
enzymes, 38-day Old Infant was observed, as well as a slightly elevated creatine kinase-MB. D-dimer was in children with SARS- day old infant [published
inflammation, found to be increased in two consecutive measurements, with subsequent CoV-2 infection; online 2020 Jun 18]. Pediatr
Italy spontaneous resolution. The infant developed mild cardiovascular comprehensive clinical, Pulmonol.
inflammation, a novelty for patients of very young age, with evidence of laboratory, and imaging doi:10.1002/ppul.24895
pericardial effusion on imaging. Hospital stay was unremarkable; no oxygen characterization is
or antiviral therapy was administered. After 14 days, the infant was provided.
discharged and tested negative for SARS-CoV-2.
Breastmilk, 17-Jun-20 A Call to Ensure Journal of Letter Declining human milk supplies in neonatal care units have become a concern In light of evidence of Rigourd V, Lapillonne A. A
neonatal care, Access to Human Human worldwide. Several arguments support the use of donor milk during the the safety of donated Call to Ensure Access to
neonates, Milk for Lactation COVID-19 epidemic. WHO does not consider human milk to be a breastmilk and Human Milk for Vulnerable
donor Vulnerable transmission vehicle for COVID-19, direct breastfeeding is still dwindling donations, Infants During the COVID-19
breastmilk, Infants During recommended, and Holder pasteurization (62.5°C for 30 min) is effective for the authors enacted a Epidemic [published online,
Paris, France, the COVID-19 preventing any SARS-CoV-2 contamination. In response to a 30-50% successful public 2020 Jun 17]. J Hum Lact.
Epidemic reduction in breastmilk donations as a result from France's COVID-19 awareness campaign in 2020; 0890334420938036.
outbreak, the authors enacted a successful campaign across Paris to train Paris, France. doi:10.1177/089033442093
donation collectors, loosen restriction criteria for donors, and spread 8036
awareness of the safety of donated breastmilk. In the final week of the
campaign, breastmilk donations were double those of the same week in
2019.
Breastmilk, 17-Jun-20 Lactoferrin Is an Acta Paediatri Brief Report Breast milk, particularly lactoferrin, demonstrates potential antiviral effects. This report highlights Peroni DG, Fanos V.
breast feeding, Important Factor ca Lactoferrin can prevent viral infections by interacting with heparin sulphate mechanisms for Lactoferrin is an important
lactoferrin, When glycosaminoglycan (HSPG) cell receptors, which allow the first anchoring site antiviral properties of factor when breastfeeding
infant, neonate, Breastfeeding on the cell surface in the first phase of coronavirus infections. Lactoferrin lactoferrin in and COVID-19 are
viral entry, and COVID-19 has previously been shown to interfere with how SARS-CoV enters human breast milk that have considered. 2020 Jun 17.
immunomodula Are Considered cultured cells by competitively localizing to the virus anchoring sites been demonstrated in Acta Paediatr.
tory effects provided by HSPGs, preventing the preliminary contact between the SARS- SARS-CoV and doi:10.1111/apa.15417
CoV and entry receptors, namely ACE2. This receptor is also used by SARS- speculates that similar
CoV-2. In addition, lactoferrin promotes the growth of gut microbiota and mechanisms may be
the proliferation of enterocytes with direct anti-inflammatory and important in SARS-CoV-
immunomodulatory actions. Although not tested in SARS-CoV-2, these 2. It calls for further
mechanisms have affected other coronaviruses. Further clinical evidence is clinical evidence.
needed to demonstrate how early breastfeeding and the specific role of
lactoferrin provides vital prevention during viral epidemics.
Breast milk, 16-Jun-20 Evaluation of medRxiv Preprint (not Between March 27 and May 6, 2020, 64 serial breastmilk samples from 18 Findings from this Chambers CD, Krogstad P,
breastfeeding, SARS-CoV-2 in peer reviewed) SARS-CoV-2-infected women residing in the U.S. were collected before and analysis of Bertrand K, et al. Evaluation
validated assay, Breastmilk from after women had a positive RT-PCR test; all but one woman had breast milk samples of SARS-CoV-2 in
culture, viral 18 Infected symptomatic disease. One sample had detectable SARS-CoV-2 RNA by RT- using validated assays Breastmilk from 18 Infected
RNA vs. Women PCR assay, which was validated by spiking breastmilk from uninfected suggest that SARS-CoV- Women [published online
replication- women with known amounts of viral RNA. The positive sample was collected 2 RNA does not 2020 Jun 16]. medRxiv.
on the day of symptom onset but one sample 2 days prior to symptom onset represent replication-
23
competent and two subsequent samples, collected 12 and 41 days later, tested negative competent virus, and doi:10.1101/2020.06.12.201
virus for viral RNA. In addition, a subset of 26 breastmilk samples from nine breast milk is an 27944
women were tested for the presence of replication-competent virus using unlikely source of
the authors' established culture methods; all were negative including the infection.
one sample that tested positive for viral RNA by RT-PCR. This suggests that
SARS-CoV-2 RNA does not represent replication-competent virus and that
breastmilk itself is likely not a source of infection for the infant.
Furthermore, when control breastmilk samples spiked with replication-
competent SARS-CoV-2 virus were treated by Holder pasteurization, a
process commonly performed by donor milk banks, no replication-
competent virus nor viral RNA was detectable. Further research to confirm
these findings is needed, as well as an examination of convalescent milk for
the presence of antibodies against SARS-CoV-2.
Neonates, 16-Jun-20 Appropriate Care Acta Clinical Overview There is currently insufficient evidence to suggest vertical transmission Given limited evidence Thi Tran H, Thi Kim Nguyen
vertical for Neonates Paediatrica between mothers and their newborn infants. However, transmission can to suggest the P, Thi Li H, et al.
transmission, Born to Mothers occur after birth from mothers or other caregivers. Based on the currently possibility of SARS-CoV- Appropriate care for
breastfeeding, With COVID-19 available data, prolonged skin-to-skin contact and early and exclusive 2 vertical transmission, neonates born to mothers
skin-to-skin Disease breastfeeding remain the best strategies to reduce the risks of morbidity and breastfeeding and skin- with COVID-19 disease
contact mortality for both mothers with COVID-19 and their newborns. to-skin contact are [published online 2020 Jun
recommended to 16]. Acta Paediatr.
preserve benefits for doi:10.1111/apa.15413
neonates born to
mothers with COVID-19.
Neonate, 15-Jun-20 Guidance on Revista da Review article The authors performed a review of the recent medical literature on The authors conclude Calil VMLT, Krebs VLJ,
breastfeeding, Breastfeeding Associação breastfeeding mothers with suspected or confirmed COVID-19, focusing on that with the currently Carvalho WB. Guidance on
breastmilk During the Médica the neonatal period. 20 recent publications on breastfeeding, COVID-19, and available information, breastfeeding during the
extraction Covid-19 Brasileira assessment of possible transmission of SARS-CoV-2 through breastmilk were any decision regarding Covid-19 pandemic. Rev
Pandemic analyzed. The review summarizes possible options for breastfeeding and breastfeeding in the Assoc Med Bras (1992).
their consequences for the mother and the child, including initiation of setting of maternal 2020;66(4):541-546.
breastfeeding, feeding by extraction of breastmilk, and not feeding the suspected or confirmed doi:10.1590/1806-
infant by breastmilk. With current knowledge, all maternal decisions in COVID-19 infection is 9282.66.4.541
relation to breastfeeding are justifiable. However, puerperal women and justifiable, and
their families must be very well informed to make a conscious choice based advocate for patient
on the information available in the literature so far. education equipping
mothers and their
families to make an
informed decision.
Neonates, 15-Jun-20 International Pediatric Clinical Research Care providers from neonatal intensive care units (NICUs) in 20 countries, This article presents a Lavizzari A, Klingenberg C,
NICU, Comparison of Research Article across six continents, exchanged and compared protocols on the detailed review of ad Profit J, et al. International
management Guidelines for management of neonates born to SARS-CoV-2-positive mothers. Disease hoc guidelines for comparison of guidelines for
protocol, Managing burden varied between countries at the time of analysis. In most countries, neonates developed by managing neonates at the
international Neonates at the asymptomatic infants were allowed to stay with the mother and breastfeed various care providers early phase of the SARS-
guidelines Early Phase of with hygiene precautions. There were discrepancies between national in different countries at CoV-2 pandemic [published
the SARS-CoV-2 guidance in particular regarding triaging, use of personal protection the start of the COVID- online 2020 Jun 15]. Pediatr
Pandemic equipment, viral testing, and visitor policies. Local protocols deviated from 19 pandemic; Res. doi:10.1038/s41390-
national guidance. Compliance between collaborators to share and discuss similarities and 020-0976-5
protocols was excellent and may lead to more consensus on management,
24
but future guidance should be built on high-level evidence, rather than differences are
expert consensus. highlighted.
Vertical 13-Jun-20 Covid-19 in Paediatric Review The aim of this review is to describe the current information available at the The authors summarize Rozycki HJ, Kotecha S.
transmission, pregnant women Respiratory time of writing regarding the potential and known effects of SARS-CoV-2 in the literature on the Covid-19 in pregnant
breastfeeding, and babies: Reviews pregnant women, their fetuses, and their newborns, to help inform potential and known women and babies: What
viral carriage, What neonatologists who might be called upon to counsel expectant mothers and effects of SARS-CoV-2 in pediatricians need to know
pregnancy, pediatricians to care for their infants. Findings showed that 1) while aspects of pregnancy pregnant women, their [published online, 2020 Jun
neonates need to know could put pregnant women at higher risk, preliminary epidemiological fetuses, and their 13]. Paediatr Respir Rev.
information does not support this; 2) viral carriage prevalence based on newborns. 2020;S1526-0542(20)30091-
universal screening showed that rates varied from 3% to 13%; 3) vertical 9.
transmission risks were unknown but 3.1% of 311 infants born to mothers doi:10.1016/j.prrv.2020.06.
with SARS-CoV-2 were positive within a week of birth; 4) the clinical 006
description of 26 neonates <30 days showed no deaths and only one
required intensive care. Risks for breastfeeding and for milk banks were also
discussed.
Neonates, 13-Jun-20 Challenges in The Indian Editorial In children, COVID-19 seems to have less severe clinical symptoms, but the To date, most studies Bhat BV, Ravikumar S.
postnatal Neonatal COVID- Journal of Commentary potential harm remains largely unknown in neonates. It is possible that the point to the possibility Challenges in Neonatal
infection, 19 Infection Pediatrics immune systems of children are less developed, and this may reduce the risk of postnatal SARS-CoV- COVID-19 Infection
vertical of cytokine storm. Routine immunization and reduced distribution of ACE2 in 2 infection of neonates [published online 2020 Jun
transmission, children may also give some protection against COVID-19. At present, rather than 13]. Indian J Pediatr.
breastfeeding studies illustrate the possibility of postnatal neonatal infection with no transplacental doi:10.1007/s12098-020-
evidence of transplacental transmission. Breastfeeding is possible in transmission. 03379-9
suspected or confirmed SARS-CoV-2 positive mothers, with proper hand and
breast hygiene. Since most neonates are seemingly infected postnatally,
health care workers must wear personal protective equipment at all times
and avoid close contact.
Infant, clinical 12-Jun-20 A 6 Months Old Travel Case Report On March 6, 2020, a 6-month-old male infant was admitted to a hospital in This is the first case of Jafari R, Cegolon L,
characteristics, Infant With Medicine and Tehran, Iran for dyspnea (without cough), poor feeding for 3 days, low grade COVID-19 in an infant, Torkaman M, et al. A 6
breastfeeding, Fever, Dyspnea Infectious fever, and increased heart rate and respiratory rate. Prior to becoming diagnosed in Iran. months old infant with
Iran and Poor Disease symptomatic, the child had been delivered premature and remained under fever, dyspnea and poor
Feeding, observation in the NICU following birth by emergency cesarean section; he feeding, diagnosed with
Diagnosed With was normally breastfed. The most significant laboratory findings were COVID-19 [published online
COVID-19 lymphopenia and increased C-reactive protein. Chest X-ray showed ill- 2020 Jun 12]. Travel Med
defined ground-glass opacities in both lungs. RT-PCR assay confirmed SARS- Infect Dis.
CoV-2 infection in both the infant and his asymptomatic mother. Following doi:10.1016/j.tmaid.2020.1
oxygen, fluids, electrolyte supplements and treatment with oseltamivir, the 01789
infant's condition progressively improved and began to tolerate
breastfeeding. Formula feeding was added because breastfeeding was
insufficient.
Pregnancy, 12-Jun-20 Coronavirus Fetal Review In this review, the authors present an evidence-based protocol for the A concise, evidence- López M, Gonce A, Meler E,
clinical Disease 2019 in Diagnosis and management of COVID-19 in pregnancy. They briefly contemplate all based protocol for the et al. Coronavirus Disease
protocol, Pregnancy: A Therapy relevant aspects that a specialist in obstetrics and maternal medicine should clinical management of 2019 in Pregnancy: A
maternal-fetal Clinical know, ranging from basic concepts about the disease and protection pregnant women with Clinical Management
management, Management measures in the obstetric setting to more specific aspects related to suspected or confirmed Protocol and Considerations
childbirth Protocol and maternal-fetal management and childbirth. Both rooming-in and COVID-19 and their for Practice [published
Considerations breastfeeding are acceptable under appropriate preventive measures. newborns is outlined. online 2020 Jun 12]. Fetal
for Practice
25
Diagn Ther.
doi:10.1159/000508487
Neonatal 12-Jun-20 Maternal BJOG: An Systematic In this review, 49 studies included information on mode of delivery and Neonatal COVID-19 Walker KF, O'Donoghue K,
infection, Transmission of International Review neonatal infection status (n=666 neonates and 655 women). 28/666 (4%) infection is uncommon, Grace N, et al. Maternal
breastfeeding, SARS-COV-2 to Journal of neonates had confirmed COVID-19 infection postnatally. Of the 291 women rarely symptomatic, and transmission of SARS-COV-2
mother- the Neonate, Obstetrics & who delivered vaginally, 8/292 (2.7%) neonates were positive. Of the 364 the rate of infection is to the neonate, and
newborn and Possible Gynecology women who had a Caesarean birth, 20/374 (5.3%) neonates were positive. no greater when the possible routes for such
separation, Routes for Such Of the 28 neonates with confirmed COVID-19 infection, 7 were breastfed, 3 baby is born vaginally, transmission: A systematic
vertical Transmission: A formula fed, 1 was given expressed breast milk; in 17 neonates the method breastfed or allowed review and critical analysis
transmission, Systematic of infant feeding was not reported. contact with the [published online 2020 Jun
systematic Review and mother. 12].
review Critical Analysis BJOG. doi:10.1111/1471-
0528.16362
Pregnancy, 12-Jun-20 Mechanisms and Prenatal Review Article Despite reports of neonatal COVID-19, SARS-CoV-2 has not been consistently The authors assessed Mahyuddin AP, Kanneganti
neonatal Evidence of Diagnosis isolated in perinatal samples thus, definitive proof of transplacental infection investigative tools used A, Wong J, et al.
infection, Vertical is still lacking. Forty studies of COVID-19 pregnancies, reviewed here, suggest to confirm maternal- Mechanisms and evidence
vertical Transmission of a lack of consensus on diagnostic strategy for congenital infection. While RT- fetal SARS-CoV-2 of vertical transmission of
transmission, Infections in PCR of neonatal swabs was universally performed, a wide range of clinical infection in various infections in pregnancy
diagnostic Pregnancy samples was screened including vaginal secretions (22.5%), amniotic fluid studies and discussed including SARS-CoV-2
strategy, Including SARS- (35%), breast milk (22.5%) and umbilical cord blood. Neonatal COVID-19 was known protective [published online 2020 Jun
placental CoV-2 reported in eight studies, two of which were based on the detection of mechanisms of the 12]. Prenat Diagn.
barrier SARS-CoV-2 IgM in neonatal blood. Histological examination demonstrated placental barrier doi:10.1002/pd.5765
sparse viral particles, vascular malperfusion and inflammation in that prevent
the placenta from pregnant women with COVID-19. The paucity of placental transplacental
co-expression of ACE-2 and TMPRSS2, two receptors involved in cytoplasmic pathogen migration.
entry of SARS-CoV-2, may explain its relative insensitivity to transplacental
infection. Viral interactions may utilize membrane receptors other than ACE-
2 thus, tissue susceptibility may be broader than currently known.
Neonates, 10-Jun-20 What Can We World Journal Viewpoint Based on six reported cases of neonatal SARS-CoV-2 infection, this article The authors provide Xiao TT, Yan K, Wang LS,
vertical Learn From of Pediatrics summarizes potential routes of vertical transmission, clinical characteristics recommendations for Zhou WH. What can we
transmission, Neonates With and management of neonates with COVID-19, as well as management of the management of learn from neonates with
clinical COVID-19? neonates born to mothers with COVID-19. In China, it is recommended that neonates with COVID- COVID-19? [published
management, all neonates born to COVID-19 positive mothers are fed with 19 or born to mothers online 2020 Jun 10]. World
breastfeeding, formula milk initially until the mother has two consecutive negative tests for with COVID-19, based J Pediatr.
China SARS-CoV-2 and is isolated for 14 days. Meanwhile, the isolated mother is on experience from doi:10.1007/s12519-020-
encouraged to keep pumping to maintain breastmilk. Delayed cord clamping China. 00376-y
and mother-newborn contact in the delivery room as also not recommended
in China.
Pregnancy, 9-Jun-20 Protect Pregnant Breastfeeding President's As the COVID-19 pandemic continue, more women are giving birth with a Due to exclusion of Stuebe A. Protect Pregnant
lactation, and Lactating Medicine Corner (Letter) SARS-CoV-2 infection. While remdesivir is emerging as a promising therapy breastfeeding and Lactating Women with
research ethics, Women With for severe disease, there is no data regarding presence of the drug in breast individuals in COVID-19 Through
remdesivir, COVID-19 milk. Before the FDA’s emergency use authorization, remdesivir was remedesivir's clinical Research, Not from
compassionate Through available for compassionate use for pregnant women; however, they were trials, the drug's Research. [published online,
use Research, Not forbidden from breastfeeding. Additionally, breastfeeding individuals were presence in breastmilk 2020 Jun 9]. Breastfeed
From Research excluded from clinical COVID-19 trials of remdesivir. This information deficit is unknown. This Med.
leads to a dilemma for both clinicians and mothers when considering presents ethical doi:10.1089/bfm.2020.2915
treatment with the drug. The association between artificial feeding and an dilemma for both 5.ams
26
increased risk of infant hospitalization for severe pneumonia must be pregnant women with
weighed against the theoretical risk of remdesivir exposure. The author COVID-19 and clinicians
points out that this type of challenge is the result of the longstanding policy when considering
of excluding pregnant and lactating individuals from clinical trials. Pregnant breastfeeding and
and lactating women deserve evidence-based treatment for medical treatment.
conditions.
Infants, 9-Jun-20 Ensuring Indian Special Article The World Health Organization recommends continuation of breastfeeding This article discusses Sachdeva RC, Jain S,
breastfeeding, Exclusive Pediatrics during the COVID-19 pandemic, and if direct breastfeeding is not challenges in ensuring Mukherjee S, Singh J.
milk banks, Human Milk Diet possible, milk expression should be explored. Pasteurized donor an exlcusive human mil Ensuring Exclusive
lactation mana for All Babies in human milk from milk banks may be used if the mother's own milk is not k diet for infants during Human Milk Diet for All
gement center, COVID-19 Times available. To universalize access to human milk, the Indian government has the COVID-19 pandemic Babies in COVID-19 Times
India proposed the establishment of comprehensive lactation management in India, as well as [published online 2020 Jun
centers/milk banks, lactation management units, and lactation support units solutions developed by 9].
at all levels of the public health system. Due to COVID-19, these centers are lactation management Indian Pediatr. 2020;S09747
encountering additional challenges cutting across interventions of rooming centers to meet this 5591600191.
in, breastfeeding, milk expression, and provision of donor milk and kangaroo challenges.
mother care. These issues and alleviation measures taken by these centers
are described in this article.
Postnatal 9-Jun-20 Postnatal SARS- Pediatric Letter to the In early March 2020, a COVID-19 outbreak at a large maternity center in This cohort Preßler J,
infection, CoV-2 Infection Allergy and Editor Germany occurred affecting 36 midwives, nurses, and doctors. Data are study describes Fill Malfertheiner S, Kabesch
neonates, and Immunology presented on all deliveries with varying degrees of unprotected parental transmission of SARS- M, et al. Postnatal SARS-
humoral Immunological contact with SARS-CoV-2 infected personnel during the CoV-2 infection from an CoV-2 Infection and
immunity, Reaction: A first, precontainment, week of the outbreak. Out of 66 families concerned, outbreak of COVID-19 Immunological Reaction: A
maternity Prospective 61 consented to a prospective study. One or both parents from 16 families among obstetric staff at Prospective Family Cohort
hospital Family Cohort reported symptoms suggestive of SARS-CoV-2 infection within 2 weeks a maternity hospital Study [published online
outbreak, Study postpartum. Three of their infants (all spontaneous births) displayed non- among postpartum 2020 Jun 9]. Pediatr Allergy
horizontal specific signs of infection similar to late-onset sepsis. Five of the 16 families women, their family Immunol.
transmission, reporting COVID-19 compatible symptoms actually contracted COVID-19 members, and doi:10.1111/pai.13302
Germany based on RT-PCR and antibody evidence. Two of the three symptomatic neonates.
neonates were RT-PCR positive and one asymptomatic neonate was
identified; no neonates had detectable antibodies. Only one mother
produced SARS-CoV-2 IgG-positive breast milk. Although the risk of vertical
transmission via breastmilk cannot be excluded, postnatal infection of
neonates through horizontal transmission is much more likely.
Pregnancy, 9-Jun-20 SARS-CoV-2 medRxiv Preprint (not An asymptomatic pregnant woman with preterm fetal distress during the In this case report, Schoenmakers S, Snijder P,
placental placental peer reviewed) COVID-19 pandemic is described. Multiple maternal, placental and neonatal SARS-CoV-2 RNA was Verdijk R, et al. SARS-CoV-2
infection, infection and swabs were obtained and showed a median viral load in maternal blood, detected on both placental infection and
adverse inflammation urine, oropharynx, fornix posterior over a period of 6 days was 5.0 log copies maternal and fetal sides inflammation leading to
fetal/neonatal leading to fetal /mL. The maternal side of the placenta had a viral load of 4.42 log copies of the placenta, and fetal distress and neonatal
outcome, PIMS- distress and /mL, while the fetal side had 7.15 log copies /mL. Maternal breast milk, feces SARS-CoV-2 particles multi-organ failure in an
TS, neonatal multi- and all neonatal samples tested negative. Serology of immunoglobulins were detected on asymptomatic woman
Netherlands organ failure in against SARS-CoV-2 was positive in maternal blood, but negative in umbilical pathological [published online 2020 Jun
an asymptomatic cord and neonatal blood. Pathological examination of the placenta included examination of the 9]. medRxiv.
woman immunohistochemical investigation against SARS-CoV-2 antigen expression placenta. doi:10.1101.2020.06.08.201
in combination with SARS-CoV-2 RNA in situ hybridization and 10437
transmission electron microscopy. It showed the presence of SARS-CoV-2
particles with generalized inflammation characterized by
27
histiocytic intervillositis with diffuse perivillous fibrin depositions with
damage to the syncytiotrophoblasts. In this case, placental infection by
SARS-CoV-2 lead to fibrin depositions hampering fetal-maternal gas
exchange most likely resulted in fetal distress necessitating a premature
emergency caesarean section. Postpartum, the neonate showed a clinical
presentation resembling a pediatric inflammatory multisystem syndrome
including coronary artery ectasia, most likely associated with SARS-CoV-2
(PIMS-TS) for which admission and care on the Neonatal Intensive Care unit
(NICU) was required, despite being negative for SARS-CoV-2.
Breastfeeding, 8-Jun-20 Breastfeeding, Journal of Research Article With regard to the care of newborns delivered by women with suspected or An overview Moro GE, Bertino E.
human milk exp Human Milk Coll Human confirmed COVID-19, the main issues of concern include: (1) breastfeeding of different strategies. Breastfeeding,
ression, breast ection and Lactation during the pandemic; (2) human milk collection and the handling of with their practical Human Milk Collection and
pump, milk ban Containers, and containers when the dyad is separated, with mothers expressing their milk; implications, to address Containers, and
king Human Milk Ban and (3) making donations of human milk to human milk banks. This report issues related to Human Milk Banking: Hot
king: Hot Topics responds to these issues with the following key messages: promoting breastfeeding and Topics During the COVID-19
During the breastfeeding whenever possible, without disregarding the option of COVID-19 is presented Pandemic [published online
COVID-19 mother's milk expression; utilizing protocols for correct handling of in this report. 2020 Jun 8]. J Hum Lact.
Pandemic human milk containers; strictly controlling human milk donors for COVID-19 doi:10.1177/089033442093
positivity at human milk banks; and allocating available donor milk to the 4391
most at-risk preterm infants given decreasing donations.
Pregnancy, 8-Jun-20 Perceptions of International Clinical Article A structured 27-item online survey was sent via social media messaging to While evidence-based Obeidat N, Saadeh R,
obstetricians, Obstetricians Journal of obstetricians and pediatricians from public, academic, and private sectors in strategies to reduce the Obeidat M, Khasawneh W,
pediatricians, and Pediatricians Gynecology & Jordan between March 23-30, 2020. A total of 147 physicians participated risks of COVID-19 in Khader Y, Alfaqih M.
online survey, About the Risk of Obstetrics (107 obstetricians, 40 pediatricians). Participants were well informed about pregnant women and Perceptions of obstetricians
Jordan COVID-19 for the symptoms, diagnosis, modes of transmission, and methods of newborns are evolving, and pediatricians about the
Pregnant prevention. Participants had variable perceptions about COVID-19 risk healthcare providers in risk of COVID-19 for
Women and during pregnancy, including potential vertical transmission, preferred route Jordan showed pregnant women and
Newborns of delivery, and safety of breastfeeding. Most participants felt that pregnant excellent knowledge of newborns [published online
women should be prioritized for testing and medical care provision. the infection and were 2020 Jun 8]. Int J Gynaecol
vigilant regarding its Obstet.
complications in these doi:10.1002/ijgo.13264
populations.
Pregnancy, 5-Jun-20 Caring for JAMA Insights Given limited data on COVID-19 in pregnancy and the effects on neonates, Existing guidelines on Rasmussen SA, Jamieson DJ.
postpartum, Women Who Are recommendations for caring for women who are planning a pregnancy, the care of pregnant Caring for Women Who Are
temporary Planning a pregnant, or have given birth during the COVID-19 pandemic are based on women with suspected Planning a Pregnancy,
separation, Pregnancy, expert opinion. There does not seem to be a compelling reason to or confirmed COVID-19, Pregnant, or Postpartum
breastfeeding, Pregnant, or recommend delaying pregnancy. For women who are pregnant, the primary who are admitted for During the COVID-19
CDC Postpartum recommendation is to avoid becoming infected through hygiene and social delivery, are Pandemic [published online
During the distancing measures. Guidelines for the care of pregnant women known or summarized. 2020 Jun 5]. JAMA Insights.
COVID-19 suspected to have COVID-19 and admitted for delivery have been developed doi:10.1001/jama.2020.888
Pandemic by the Centers for Disease Control and Prevention and professional 3
organizations and are summarized here. Issues related to hospital placement
of the newborn born to a mother with COVID-19 are challenging; shared
decision-making between the mother and the care is recommended. For
those who select temporary separation, expression of breast milk with
hygiene precautions should be encouraged. A mother who chooses to room
28
with her newborn should use a face mask and careful hand and breast
hygiene before breastfeeding.
Nutritional 5-Jun-20 An urgent call to International Original article In Nepal, communities and vulnerable groups like women and children This article summarizes Panthi B, Khanal P, Dahal M,
status, women, address the Journal for dealing with malnutrition are doubly susceptible to compromised health due nutritional concerns in Maharjan S, Nepal S. An
children, Nepal nutritional status Equity in to the COVID-19 pandemic. In addition, the lockdown has resulted in a Nepal during this urgent call to address the
of women and Health decrease in household incomes leading to less availability and reduced pandemic, and argue nutritional status of women
children in Nepal access to food, and restriction in receiving essential health care services. that nutrition should and children in Nepal during
during COVID-19 Nutrition services through the outpatient therapeutic center and nutrition thus be a core COVID-19 crises. Int J Equity
crises rehabilitation homes have also been affected as a result of the priority shift component of the Health. 2020;19(1):87.
of the health sector towards COVID-19. Insufficient breastfeeding practices, COVID-19 response Published 2020 Jun 5.
due to fear and anxiety of transmission of COVID 19 from breastfeeding plan, integrated into doi:10.1186/s12939-020-
mothers, result in decreased feeding and caring practices for children. The each aspect of 01210-7
possible ways to ensure better nutrition among women and children in prevention, treatment,
resource-constrained settings like Nepal could be a combination of different and recovery.
measures. The authors argue for developing and implementing mitigation
strategies to reach out to those most affected by the crisis and activation
and functionality of nutrition clusters to ensure a predictable, timely, and
effective nutrition response. Program and service to promote breastfeeding
and feeding practices should remain a critical component. Counseling and
psychological support to mothers and caregivers of under 5-year children
are required as well as ensuring nutrition commodities are available and
accessible.
Neonates, 5-Jun-20 Manifestations The Indian Scientific Letter The authors report two neonates born to COVID-19 positive women. The Lack of evidence for Jain P, Thakur A, Kler N,
vertical in Neonates Born Journal of first neonate was born at term via emergency cesarean section due to fetal transplacental Garg P. Manifestations in
transmission, to COVID-19 Pediatrics distress. A neonatal RT-PCR was sent at 18 hours of life and was negative. transmission of SARS- Neonates Born to COVID-19
fetal distress, Positive Mothers The mother wore a mask and breastfed the neonate; both remained well on CoV-2 infection in this Positive Mothers [published
hypoxic- follow up. The second neonate was also delivered via cesarean section due case report of two online 2020 Jun 5]. Indian J
ischemic to fetal distress and meconium stained liquor, requiring resuscitation at birth neonates is consistent Pediatr.
encephalo- followed by mechanical ventilation. The neonate developed shock and later with recent doi:10.1007/s12098-020-
pathy, India seizures, while brain MRI revealed subdural hemorrhage. Neonatal publications. 03369-x
nasopharyngeal swabs for SARS-CoV-2 RT-PCR were negative on days 3, 5,
and 8 of life, and the neonate was discharged on day 12 after recovering
from hypoxic-ischemic encephalopathy.
Pregnancy, 5-Jun-20 Management of Klinische Diagnostic and The German Society for Pediatric Infectious Diseases in accordance with the Several professional Simon A, Hübner J, Knuf M,
neonates, Care for Pädiatrie Treatment German Society for Gynecology and Obstetrics and the German Society for societies from Germany Hufnagel M, Berner R.
management, Neonates Born Recommen- Perinatal Medicine releases this statement on recommendations for the outline Management of Care for
viral to SARS-CoV-2 dation management of neonates born to SARS-CoV-2 positive women. Both recommendations for Neonates Born to SARS-
transmission, Positive Women background information on SARS-CoV-2 transmission as well as potential the management of CoV-2 Positive Women with
breastfeeding, With or Without scenarios are presented. Since possible transmission through respiratory neonates born to or without Clinical
Germany Clinical droplets or close mother-child contact constitutes the greatest risk of mothers with COVID-19. Symptoms (COVID-19)
Symptoms infection, the authors outline important hygiene measures to prevent [published online 2020 Jun
(COVID-19) infection while breastfeeding. 5]. Klin Padiatr.
doi:10.1055/a-1168-2845
29
Pregnancy, 4-Jun-20 Breastfeeding Ris Journal of Letter to the Five hospitalized pregnant women with COVID-19 in their third trimester SARS-CoV-2 RNA was Zhu C, Liu W, Su H, et al.
breast milk sam k From Infection Editor presented with clinical symptoms and imaging consistent with SARS-CoV-2 detected in consecutive Breastfeeding Risk from
ple, Detectable infection. Four patients had cesarean delivery, while one patient delivered breastmilk samples of Detectable Severe Acute
breastfeeding, Severe Acute her newborn vaginally. All patients experienced favorable clinical outcomes. one puerperal woman Respiratory Syndrome
China Respiratory All available vaginal secretion samples were negative for SARS-CoV-2, in this case series from Coronavirus 2 in
Syndrome whereas SARS-CoV-2 RNA was detected in breastmilk samples collected Wuhan, China. Breastmilk [published online
Coronavirus 2 in from one patient on days 2 and 3 post-delivery (RT-PCR Ct values of 38.2 and 2020 Jun 4]. J
Breastmilk 38.5 respectively). The clinical characteristics of this patient were similar Infect. doi:10.1016/j.jinf.20
to those of other COVID-19 positive women with negative 20.06.001
breastmilk results.
Pregnancy, 4-Jun-20 Relationship The Journal of Review Article Pregnancy is characterized by changes involving both the immune system A current review of Forestieri S, Marcialis MA,
neonates, Between Maternal- and the pulmonary physiology, exposing the pregnant woman to a greater literature of COVID-19 Migliore L, Panisi C, Fanos V.
vertical Pregnancy and Fetal & susceptibility to viral infections and more serious complications. The in pregnancy and Relationship between
transmission, Coronavirus: Neonatal objective of this review is to analyze the relationship between pregnancy comparison to other pregnancy and coronavirus:
breastfeeding, What We Know Medicine and known coronaviruses, with particular reference to SARS-CoV-2. The coronaviruses are what we know [published
coronaviruses, molecular bases of immunology and pregnancy are discussed, as well as offered. online 2020 Jun 4]. J Matern
SARS, MERS documented clinical findings in literature. On the basis of available data, Fetal Neonatal Med.
COVID-19 appears neither more frequent nor more serious in pregnancy doi:10.1080/14767058.2020
than in non-pregnant women. Perinatal adverse events have been .1771692
observed but are milder than in SARS and MERS, with preterm delivery
representing the main complication of COVID-19 in pregnancy. In addition,
breastfeeding is recommended in COVID-19 since viral transmission via
breast milk has not been demonstrated. Looking ahead, further research on
maternal immune activation in COVID-19 is needed, to understand the
effects of exposing the fetus to inflammatory response.
Neonatal 3-Jun-20 Neonatal SARS- Clinics (Sao Letter A male neonate was born vaginally at full term; the mother's amniotic Favorable clinical Carvalho WB, Gibelli MAC,
infection, CoV-2 Infection Paolo) membranes had ruptured 11 hours before delivery. He presented with early course of COVID-19 is Krebs VLJ, Calil VMLT,
ruptured respiratory distress, which improved after receiving inhaled oxygen in the described in a male Nicolau CM, Johnston C.
amniotic first 12 hours of life. Blood examinations were normal, and chest neonate, who remained Neonatal SARS-CoV-2
membranes, radiography showed a left clavicle fracture. The patient was discharged breastfed from birth infection. Clinics (Sao
breastfeeding, home on the third day of life, on exclusive breastfeeding. At home, family and throughout the Paulo). 2020;75:e1996.
horizontal members complied with isolation requirements, and the newborn had no recovery process. doi:10.6061/clinics/2020/e1
transmission, contact with other patients with flu-like symptoms. On day 11 of life, the 996
Brazil newborn had two episodes of hyperthermia and mild respiratory distress.
Nasal and oropharyngeal samples for SARS-CoV-2 were positive by RT-PCR.
The neonate had favorable clinical course while hospitalized and remained
mostly breastfed (he was given formula only when breast milk was
unavailable).
Pregnancy, 2-Jun-20 Excretion of Clinical Letter to the In this report, two pregnant women were admitted to a hospital in Rome, Testing from various Costa S, Posteraro B,
neonates, Sars-Cov-2 in Microbiology Editor Italy and tested positive for SARS-CoV-2. Both patients were in their third body sites or fluids of Marchetti S, et al. Excretion
human milk sa Human and Infection trimester and underwent cesarean section following fetal distress. Both pregnant women with of Sars-Cov-2 in human
mples, Breastmilk Sampl neonates did not receive breastmilk, as a precaution. In one mother, viral COVID-19 is needed to breastmilk samples
breastfeeding, es RNA was detected in multiple breastmilk samples, collected on subsequent assess potential [published online 2020 Jun
Italy days after delivery, as well as placental tissue and cord blood samples. Cycle mother-to-child 2]. Clin Microbiol
threshold value of less than 40 (interpreted as positive for SARS-CoV-2 RNA) transmission of SARS- Infect. doi:10.1016/j.cmi.20
in three of six breastmilk samples indicate excretion of virus into CoV-2 by extra- 20.05.027
breastmilk. Thus, the authors recommend against the practice of respiratory routes.
30
breastfeeding until the mother has achieved viral clearance. Assessment for
live virus isolation was not performed in clinical samples in this study.
Pregnancy, 1-Jun-20 Safety of medRxiv Preprint (not To evaluate the effect of breastfeeding on SARS-CoV-2 transmission, the Findings from this small Luo Q, Chen L, Yao D, et al.
neonates, Breastfeeding in peer reviewed) presence of SARS-CoV-2, IgG and IgM in breast milk, maternal blood and number of cases Safety of Breastfeeding in
breastfeeding, Mothers with infant blood were assessed in this study. Among 23 pregnant women with suggest that there is Mothers with SARS-CoV-2
breast milk sam SARS-CoV-2 suspected (n=9) or confirmed (n=14) SARS-CoV-2 infection in the third currently no evidence Infection [published online
ples, IgM and Infection trimester or puerperium, all breast milk samples were negative for the for mother-to-child viral 2020 Jun 1]. medRxiv.
IgG antibodies, detection of SARS-CoV-2. Testing for IgM and IgG antibodies in transmission via doi:10.1101/2020.05.30.200
China breast milk and maternal blood was performed in seven patients; IgM breastfeeding in 33407
antibodies were present in four confirmed patients and one suspected women with COVID-19
patient, correlating with IgM detection in maternal blood. IgG antibodies in the third trimester
were not detected in any breast milk sample. SARS-CoV-2 testing by throat and puerperium.
swab was performed in 15 neonates at birth and in six neonates in the NICU
after birth; all results were negative. Following birth, all neonates were in
healthy condition, and six were fed with whole or partial breast milk. Eight
neonates received SARS-CoV-2 antibody testing one month after birth, and
all results were negative.
Human milk, 1-Jun-20 Wet Nurses to Journal of Editorial This article summarizes the importance of breastfeeding and wet nursing. This article argues that Marinelli KA. Wet Nurses to
donor milk, Donor Milk Human The author goes into detail on donor milk banking as the logical next step in donor milk banking has Donor Milk Banks and Back
donor milk Banks and Back Lactation the evolution of mothers sharing milk directly to others to sustain life within become an important Again: The Continuum of
banking, wet Again: The a society. The author argues it is efficacious to collect and store the milk in a portion of how we Sharing Our Milk to Save
nursing, infant Continuum of central place which is also responsible for donor and milk testing, from supplement infants who Lives. J Hum Lact.
morbidity, Sharing Our Milk where it can be distributed to those in need, even at great distances. There do not or cannot 2020;36(2):213-216.
infant to Save Lives are increasing numbers of emergencies in which large numbers of families receive a diet of doi:10.1177/089033442092
mortality, are displaced, accompanied by a myriad of associated life-threatening exclusive mother’s own 7329
exclusive problems. A current example of this type of emergency is the COVID-19 milk, and it plays a
breastfeeding, pandemic. New research is emerging, and guidance for mothers and their significant role in this
breastfeeding, newborns on proximity, skin-to-skin contact, and feeding appears from a pandemic.
healthcare variety of sources with conflicting messages. WHO recommends that if the
disparities, mother is too unwell to breastfeed or express breastmilk, explore the
supplementatio viability of relactation, wet nursing, donor human milk, or appropriate
n, altruism breastmilk substitutes.
Human milk sa 30-May-20 Detectable Clinical Brief Report In this case, a 40-year-old female with mild clinical symptoms tested positive This case report Tam PCK, Ly
mples, Severe Acute Infectious for SARS-CoV-2 on RT-PCR testing of a combined oro/nasopharyngeal swab. describes an actively KM, Kernich ML, et al.
breastfeeding, Respiratory Diseases Her 8-month-old son, who had been breastfed until the day of maternal breastfeeding patient Detectable severe acute
viral Syndrome symptom onset, also tested positive for SARS-CoV-2; upon confirmed SARS- with SARS-CoV-2 respiratory syndrome
transmission Coronavirus 2 CoV-2 infection in the infant, breastfeeding was resumed with no adverse infection with coronavirus 2 (SARS-CoV-2)
(SARS-CoV-2) in effects. The mother had detectable viral RNA in human milk in two separate detectable viral RNA in in human breast milk of a
Human samples taken 10 days apart (5 and 15 days after maternal symptom onset, human milk; the mildly symptomatic patient
Breast Milk of a respectively) but interspersed with a number of negative results. patient's infant also with coronavirus disease
Mildly Contamination from the infant's oropharynx is unlikely because tested positive for 2019 (COVID-19) [published
Symptomatic breastfeeding was stopped for five days prior to collection of the first sample SARS-CoV-2, but no online 2020 May 30]. Clin
Patient With and all samples thereafter were collected prior to feeding. The risk of adverse effects from Infect Dis.
Coronavirus environmental contamination is also unlikely given appropriate hand breastfeeding were doi:10.1093/cid/ciaa673
Disease 2019 hygiene and resolution of maternal respiratory symptoms at time of sample noted and viral
(COVID-19) collection. There appeared to be no relationship between RT-PCR cycle transmission via
threshold values from the patient's or infant's oropharyngeal samples with human milk is
31
viral RNA detection in human milk. Although SARS-CoV-2 RNA was identified concluded unlikely by
in human milk samples, whether this translates to viable virus or degraded the authors.
residual nucleic acid could not be ascertained. Due to the infant's travel
history and close contact with the mother, viral transmission via
breastfeeding is presumed to be unlikely by the authors. Thus, the benefits
of human milk likely greatly outweigh risks associated with maternal SARS-
CoV-2 infection, due to conferring protection to other respiratory illnesses.
Human milk, 30-May-20 SARS-CoV-2 and Maternal & Review Article There is limited published literature related to vertical transmission of any Limited reports on the Lackey KA, Pace RM,
breastfeeding, Human Milk: Child human coronaviruses via human milk and/or breastfeeding. Results of the presence of human Williams JE, et al. SARS-CoV-
human What Is the Nutrition present literature search revealed a single study providing some evidence of coronaviruses, including 2 and human milk: What is
coronaviruses, Evidence? vertical transmission of human coronavirus 229E; a single study evaluating SARS-CoV-2, in the evidence? [published
assay presence of SARS‐CoV in human milk (it was negative); and no published human milk are online 2020 May 30].
validation data on MERS‐CoV and human milk. In total, 13 studies reporting described; these studies Matern Child Nutr.
human milk tested for SARS‐CoV‐2 were identified; one study detected the do not report methods doi:10.1111/mcn.13032
virus in one milk sample, and another study detected SARS‐CoV‐2 specific of sample collection or
IgG in milk. Importantly, none of the studies on coronaviruses and validation of assays for
human milk report validation of their collection and analytical methods for human milk.
use in human milk. In addition, little remains known about the timing of
antibody response in human milk to SARS-CoV-2 infection. Future research
should utilize validated methods and focus on both potential risks and
protective effects of breastfeeding.
Pregnancy, risk 29-May-20 The outbreak of Women and Original Research Using cross-sectional survey design, a four-section online questionnaire was Although surveyed Lee TY, Zhong Y, Zhou J, He
perceptions, coronavirus Birth administered to 161 prenatal and postnatal women during the COVID-19 prenatal and postnatal X, Kong R, Ji J. The outbreak
knowledge, disease in China: outbreak in Nanjing, China, in February 2020. The participants perceived women demonstrated of coronavirus disease in
breastfeeding, Risk perceptions, their risk of contracting and dying from COVID-19 to be lower than their risk adequate knowledge China: Risk perceptions,
China knowledge, and of contracting influenza, however many of them were worried that they about COVID-19, they knowledge, and information
information might contract COVID-19. The participants demonstrated adequate had misunderstood sources among prenatal and
sources among knowledge about COVID-19. The three major sources from which they some of the WHO postnatal women
prenatal and obtained information about COVID-19 were doctors, nurses/midwives, and recommendations. [published online 2020 May
postnatal the television. The majority of women thought neonates of pregnant women 29]. Women Birth.
women with suspected or confirmed COVID-19 should be isolated for at least 14 doi:10.1016/j.wombi.2020.0
days after birth and that women with suspected or confirmed COVID-19 5.010
should not breastfeed their neonates.
Pregnancy, 29-May-20 Breastfeeding Diabetes Review Breastfeeding improves the health of mother and child and reduces risk of A summary of Giuliani C, Li Volsi P, Brun E,
breastfeeding, During the Research and neonatal infection with other pathogens that are likely to cause serious recommendations in et al. Breastfeeding during
diabetes, COVID-19 Clinical illness. To date, no evidence has confirmed COVID-19 vertical transmission support of the COVID-19 pandemic:
recommen- Pandemic: Practice from infected mother to fetus. However, it is well known that an infected breastfeeding in suggestions on behalf of
dations, Italy Suggestions on mother can transmit the SARS-CoV-2 virus through respiratory droplets mothers with suspected Woman Study Group of
Behalf of during breastfeeding or intimate contact. Thus, mothers with known or or confirmed COVID-19 AMD [published online 2020
Woman Study suspected COVID-19 should adhere to standard and contact precautions is presented. May 29]. Diabetes Res Clin
Group of AMD during breastfeeding. After reviewing current knowledge about COVID-19 Pract.
vertical transmission and the compatibility of breastfeeding in COVID-19 doi:10.1016/j.diabres.2020.
positive mothers, the Woman Study Group of AMD has compiled available 108239
recommendations, from health care organizations and expert opinions, to
facilitate mother-newborn interaction and the initiation of breastfeeding,
addressing both mothers with and without diabetes.
32
Neonates, cord 28-May-20 Delayed European Correspondence Newborns are more vulnerable to the potential consequence of COVID-19 This brief Kohan S, Rahnemaei FA.
clamping, Umbilical Cord Journal of due to their immature immune systems. Currently, there is insufficient correspondence argues Delayed umbilical cord
breastfeeding, Clamping and Obstetrics & evidence for vertical transmission from mother to fetus via amniotic fluid, against delayed clamping and breastfeeding
isolation, skin- Breastfeeding Gynecology umbilical blood or breast milk. Since respiratory droplets are a major route umbilical cord clamping after childbirth in mothers
to-skin contact After Childbirth and of transmission to the infant during the delivery process, early cord but in favor of affected by COVID 19:
in Mothers Reproductive clamping, immediate isolation of the newborn, and lack of skin-to-skin breastfeeding in Recommended or not?
Affected by Biology contact can reduce the newborn's risk of infection. If a mother is generally newborns born to [published online 2020 May
COVID 19: well, breastfeeding should be allowed while observing hygiene precautions. mothers with COVID- 28]. Eur
Recommended 19. J Obstet Gynecol Reprod Bio
or Not? l. doi:10.1016/j.ejogrb.2020.
05.041
Maternal 27-May-20 Coronavirus Revista Review The review aims to investigate the action plan on breastfeeding in This review argues that Fernández-Carrasco FJ,
breastfeeding, Covid-19 Española de postpartum women with SARS-CoV-2 and her newborn. A literature search the newborns should be Vázquez-Lara JM, González-
neonate, infection and Salud Pública was conducted through the Medline, Web of Science, Scopus, BVS, and breastfed if the Mey U, Gómez-Salgado J,
pregnancy breastfeeding: Cuiden databases. A total of 14 documents have been found, of which 9 are maternal and child Parrón-Carreño T,
an exploratory observational empirical studies. Most of the studies were conducted in health status allows it Rodríguez-Díaz L. Infección
review China, Italy, the USA, and Australia. A total of 114 mothers infected with and appropriate por coronavirus Covid-19 y
[Access to SARS-CoV-2 with their respective newborns have been assessed. The results hygiene measures lactancia materna: una
Abstract in suggest that newborns should be breastfed and detecting the presence of should be considered. revisión exploratoria
English Only; antibodies of the coronavirus in them is a protective factor against infection. [Coronavirus Covid-19
Article in Breastfeeding in postpartum women with SARS-CoV-2 is highly infection and breastfeeding:
Spanish] recommended for the newborn if the health of the mother and newborn an exploratory review]. Rev
allows it. When direct breastfeeding is favored, the appropriate respiratory Esp Salud Publica.
hygiene measures should be considered. If the mother's health does not 2020;94:e202005055.
permit direct breastfeeding, her breast milk should be previously extracted Published 2020 May 27.
and kept unpasteurized. To secure newborn feeding, milk banks are also an
appropriate option.
Human milk, 27-May-20 The impact of medRxiv Preprint Thermal pasteurization (62.5°C, 30 min) of human milk (HM) is thought to This review describes Pitino MA, O'Connor
viral load, thermal (not peer reduce the risk of transmitting viruses to an infant. Some viruses may be the effect of thermal DL, McGeer AJ, Unger S. The
thermal pasteurization reviewed) secreted into milk; others may be contaminants. Primary research articles pasteurization on impact of thermal
pasteurization, on viral load in until April 20, 2020 were identified to assess the impact of pasteurization on reducing detectable live pasteurization on viral load
coronaviruses human milk and viral load or detection of live virus. Reviews were excluded, as were studies viruses, like in human milk and other
other matrices: A lacking quantitative measurements or those assessing pasteurization as a coronaviruses, in matrices: A rapid review
rapid review component of a larger process. Overall, 65,131 reports were identified, and human milk. [published online 2020 May
108 included. Pasteurization of HM at a minimum temperature of 56°C-60°C 27]. medRxiv.
is effective at reducing detectable live virus. In cell culture media or plasma, doi:10.1101/2020.05.23.201
coronaviruses (e.g., SARS-CoV, SARS-CoV-2, MERS) are highly susceptible to 11369
heating at ≥56°C. Future research should standardize pasteurization
protocols and test viral inactivation using a human milk matrix.
Perinatal 27-May-20 Covid-19 and the Journal of Comment In ordinary times, the experience of a NICU hospitalization is a potentially This article discusses Hynan MT. Covid-19 and the
mental health, Need for Perinatology traumatic event for the newborn's parents. A published estimate of the the need to incorporate need for perinatal mental
NICU staff, Perinatal Mental prevalence of diagnosable mental disorders in NICU parents in the first more perinatal mental health professionals: now
post-traumatic Health partum year is 20–30%. To the author's knowledge, the highest report of health staff into NICUs, more than ever before
stress Professionals: parental post-traumatic stress symptoms in the literature (60% of mothers to support parents, [published online 2020 May
Now More Than and 47% of fathers exceeding threshold) comes from a NICU that had strict newborns, and staff 27]. J Perinatol.
Ever Before limitations on skin-to-skin care and breastfeeding (not allowed) and experiencing added doi:10.1038/s41372-020-
visitation curtailment to one parent at a time. The current pandemic's 0696-z
33
limitations on parental engagement with newborns in the NICU, as well as stress during this
exclusion of partners from labor and delivery will have serious effects on the pandemic.
wellbeing of families. Currently, most NICU social workers and psychologists
are considered non-essential. Strategies to add mental health staff in the
perinatal setting must be incorporated into discussions to promote the
psychological health of parents, newborns, and NICU workers.
Pregnancy, 26-May-20 When Separation Maternal & Original Article The WHO has provided detailed guidance on the care of infants of women This article discusses Tomori C, Gribble K,
neonates, Is Not the Child who are a person under investigation (PUI) or confirmed to have COVID-19, the potential detriment Palmquist AEL, Ververs MT,
separation Answer: Nutrition which supports immediate postpartum mother-infant contact and al effects of separation Gross MS. When Separation
policies, Breastfeeding breastfeeding with appropriate respiratory precautions. Although many policies in settings that is not the Answer:
breastfeeding, Mothers and countries have followed WHO guidance, others have implemented infection have not followed Breastfeeding Mothers and
WHO Infants Affected prevention and control policies that impose varying levels of postpartum WHO-directed guidance Infants affected by COVID-
by COVID-19 separation and discourage or prohibit breastfeeding or provision of promoting proximity 19 [published online
expressed breastmilk. These policies aim to protect infants from and breastfeeding for 2020 May 26]. Matern
the potential harm of infection from their mothers, yet they may fail to fully COVID-19 affected Child Nutr.
account for the impact of separation. Global COVID-19 data are suggestive of mothers and infants. doi:10.1111/mcn.13033
potentially lower susceptibility and a typically milder course of disease
among children, although the potential for severe disease in infancy
remains. Separation causes cumulative harms, including disrupting
breastfeeding and limiting its protection against infectious disease, which
has disproportionate impacts on vulnerable infants. Separation also
presumes the replaceability of breastfeeding––a risk that is magnified in
emergencies. Moreover, separation does not ensure lower viral exposure
during hospitalizations and post-discharge and contributes to the burden on
overwhelmed health systems. Finally, separation magnifies maternal health
consequences of insufficient breastfeeding and compounds trauma in
communities who have experienced long-standing inequities and violence,
including family separation. Taken together, separating PUI/confirmed SARS-
CoV-2 positive mothers and their infants may lead to excess preventable
illnesses and deaths among infants and women around the world.
Children, viral 26-May-20 Protecting BMJ Global Editorial Based on child pneumonia experience, COVID-19, a viral pneumonia The authors draw on Ahmed S, Mvalo T, Akech S,
pneumonia, Children in Low- Health syndrome, may impact children in low- and middle-income countries (LMICs) their shared child et al. Protecting children in
risk factors, Income and more severely than what has been observed to date in high-income pneumonia experience low-income and middle-
LMICs Middle-Income countries (HICs). Risk factors for poor outcomes in pneumonia are globally to highlight the income countries from
Countries From overwhelmingly more prevalent in LMICs; these include severe malnutrition, potential impacts of COVID-19. BMJ Glob Health.
COVID-19 low immunization uptake, nutritional anemia, HIV exposure or infection, air COVID-19 on children in 2020;5(5):e002844.
pollution, poverty, low parental education and, crucially, limited access to LMICs and propose doi:10.1136/bmjgh-2020-
high-quality acute healthcare. The indirect effects of the COVID-19 response actions for a collective 002844
also require attention, for example widespread parental unemployment, response.
disrupted education, food and housing insecurity and threats to vital
preventive health programs, like immunization, antenatal care, infant
feeding and mental health. The authors suggest that vital services and health
workforce must be maintained, COVID-19 testing must be scaled up in
LMICs, lockdown strategies should be tailored to specific environments, and
further research on COVID-19 in children must be conducted.
34
Pregnancy, 26-May-20 Complications Hypertension Review A systematic search of relevant databases was performed on March 25 and a This review adds to the Teles Abrao Trad
neonates, and Outcomes of in Pregnancy repeat search, on April 10, 2020. Reports of pregnant patients with SARS- growing evidence on A, Ibirogba ER, Elrefaei A, et
maternal SARS-CoV-2 in CoV-2 infection at any time during their pregnancy were reviewed, and the SARS-CoV-2 al. Complications and
outcomes, Pregnancy: outcomes of 155 pregnant women and 118 neonates were summarized. The infection during outcomes of SARS-CoV-2 in
cesarean Where and What evidence suggests a similar rate of severe COVID-19 cases in pregnant pregnancy and pregnancy: where and what
delivery, Is the Evidence? women and the general population. The frequency of cesarean deliveries is calls for improvement is the evidence? [published
breast milk, high, against guidelines recommendations, of the level of quality of online 2020 May
systematic and requires clarification. Placenta, amniotic fluid, umbilical cord blood, the studies to allow 26]. Hypertens Pregnancy.
review breastmilk, gastric juice, urine, and feces were all screened for SARS-CoV-2 evidence-based doi:10.1080/10641955.2020
in different studies and were reported as negative suggesting a possible lack decisions regarding .1769645
of vertical transmission. There are limited data on COVID-19 pregnant patients.
during pregnancy, associated with wide variations in methodology that make
accurate data interpretation difficult.
Pregnancy, 26-May-20 Sars-CoV-2 in the Prenatal Review This narrative review describes current knowledge about coronaviruses A review of corona- Lambelet V, Vouga M,
neonates, Context of Past Diagnosis (SARS, MERS and SARS-CoV-2) and their risks and consequences on viruses in pregnancy, Pomar L, et al. Sars-CoV-2 in
adverse Coronaviruses pregnancies. A summary of available candidate therapeutic options for current therapeutic the context of past
maternal Epidemics: pregnant women is also offered with consideration of the compatibility of options for pregnant coronaviruses epidemics:
outcomes, Consideration described drugs with breastfeeding and their excretion into breastmilk. The women with COVID-19 Consideration for prenatal
SARS-CoV, for Prenatal authors also compare guidance proposed by the Royal College of (with care [published online 2020
MERS- Care Obstetricians (RCOG), American College of Obstetricians and considerations for breas May 26]. Prenat Diagn.
CoV, prenatal Gynecologists (ACOG), and the WHO to give an overview of prenatal tfeeding), and doi:10.1002/pd.5759
guidance management which should be utilized until future data appear. comparison of
current guidance on
perinatal management
are provided.
Labor and 22-May-20 Labor and JAMA Viewpoint Although variation exists in visitor policies, many hospitals have instituted a This article considers Arora KS, Mauch JT, Gibson
delivery, visitor Delivery Visitor limit of 1 adult visitor for each patient in labor and delivery units. As the risks and benefits of KS. Labor and Delivery
policy, labor Policies During recommended by the Centers for Disease Control and Prevention and the restrictive visitory Visitor Policies During the
companionship, the COVID-19 American College of Obstetricians and Gynecologists, this visitor should be policies on labor and COVID-19 Pandemic:
breastfeeding Pandemic: afebrile and screened for symptoms prior to entry. Apart from the emotional deliver units. Balancing Risks and Benefits
Balancing Risks rationale, ethical and clinical reasoning supports excluding labor and delivery [published online 2020 May
and Benefits units from visitor prohibition policies. As noted by the WHO, continuous 22]. JAMA.
companionship during labor is recommended for all pregnant women to doi:10.1001/jama.2020.756
potentially improve labor outcomes. In addition, although guidelines to 3
physically distance infants are evidence-based, they are not pragmatic.
Many families, especially if both the patient and visitor are SARS-CoV-2
positive, lack the resources to isolate from the newborn for 14 days.
Furthermore, risk of harm to bonding and breastfeeding initiation exists.
Implementing a labor and delivery unit visitor policy necessitates balancing
risks and benefits to the patient, the visitor, the community, the health care
team, and the infant.
Breast milk, 22-May-20 SARS-CoV-2 Frontiers in Review This review focused on the scarce information about COVID-19's clinical Infant treatment for Ovalı F. SARS-CoV-2
newborn, Infection and the Pediatrics features, laboratory findings and prognosis in children and newborns. Since COVID-19 is mainly Infection and the Newborn.
pregnancy Newborn they are asymptomatic or mildly symptomatic, the majority of children do symptomatic, and anti- Front Pediatr. 2020;8:294.
not undergo diagnostic investigations. Children who become infected with viral treatment is not doi:10.3389/fped.2020.002
SARS-CoV-2 may have more upper respiratory tract than lower respiratory generally needed in 94
tract involvement. While there is no specific treatment for the disease, but newborns. There are no
35
hemodynamic stabilization of the infant, respiratory management and other data on the efficacy of
daily care are essential. Drugs against cytokine storm syndrome such as anti-viral drugs in the
corticosteroids or tocilizumab are under investigation, and this study found newborn population.
that routine antibiotics are not recommended. Antibiotics may be used if This paper also
there is secondary bacterial infection. Standard immunoglobulins or discusses findings
hormonal treatments are not helpful. There is currently no information on related to breastmilk
the long-term effects of COVID-19 acquired in the neonatal period. and SARS-CoV-2.
Neonatal 22-May-20 A Case Report of Journal of the Case Report On April 1, 2020, a 10-day-old male infant (born at 39 weeks' gestation via This case presents a Precit MR, Yee R, Anand V,
infection, acute Neonatal Acute Pediatric normal spontaneous vaginal delivery) presented to the Emergency unique presentation of Mongkolrattanothai K,
respiratory Respiratory Infectious Department (ED) with increased nasal secretion and labored breathing, respiratory failure due Pandey U, Dien Bard J. A
failure, USA Failure Due to Diseases approximately 1 week after exposure to family members who had upper to SARS-CoV-2 in a Case Report of Neonatal
SARS-CoV-2 Society respiratory symptoms the week prior. At the ED, laboratory and clinical neonatal patient. Acute Respiratory Failure
findings were consistent with hypoxic respiratory failure. On admission to Due to SARS-CoV-2
the PICU, increased nasal flaring and secretions, increased ‘work of [published online 2020 May
breathing’, subcostal retractions, and lethargy were noted, and SARS-CoV-2 22]. J Pediatric Infect Dis
was detected by RT-PCR on his nasopharyngeal (NP) swab. On day 3, the Soc.
patient was successfully weaned off nasal cannula oxygen to room air and doi:10.1093/jpids/piaa064
was discharged the following day. Five days later, the patient returned with
increased nasal congestion, subcostal retractions, and decreased feeding. NP
swabs from both the patient and the mother tested positive for SARS-CoV-2;
the infant's NP swab showed qualitatively lower viral load than the first
specimen tested five days prior. The patient's respiratory symptoms
resolved, and he was discharged the next morning.
Pregnancy, 22-May-20 Clinical Course of Acta Original Article Data on the first 60 pregnant women with COVID-19 at the Puerta de Hierro In this study of Pereira A, Cruz-Melguizo S,
neonates, Coronavirus Obstetricia et University Hospital, Madrid, Spain from March 14 to April 14, 2020 were pregnant patients with Adrien M, Fuentes L, Marin
severe Disease-2019 Gynecologica reviewed. The most common symptoms were fever and cough (75.5%, each) COVID-19, CRP and D‐ E, Perez-Medina T. Clinical
pneumonia, (COVID-19) in Scandinavica followed by dyspnea (37.8%). 41 patients (68.6%) required hospital dimer levels positively course of Coronavirus
inflammatory Pregnancy admission (18 due to disease worsening and 23 for delivery) of whom 21 correlated with severe Disease-2019 (COVID-19) in
markers, patients (35%) underwent pharmacological treatment, including pneumonia and the pregnancy [published online
neutrophil hydroxychloroquine, antivirals, antibiotics and tocilizumab. No renal or neutrophil/lymphocyte 2020 May 22]. Acta Obstet
/lymphocyte cardiac failures or maternal deaths were reported. Lymphopenia (50%), ratio decreased as the Gynecol Scand.
ratio, thrombocytopenia (25%), and elevated C‐reactive protein (CRP) (59%) were patients improved doi:10.1111/aogs.13921
breastfeeding, observed in the early stages of the disease. Median CRP, D‐dimer and the clinically. No cases of
Spain neutrophil/lymphocyte ratio were elevated. High CRP and D‐dimer levels vertical or horizontal
were the parameters most frequently associated with severe pneumonia. transmission were
The neutrophil/lymphocyte ratio was found to be the most sensitive marker diagnosed in neonates,
for disease improvement (relative risk: 6.65; 95% CI: 4.1‐5.9). During the breastfed or not.
study period, 23 women delivered, 18 (78%) vaginally. All newborns tested
negative for SARS‐CoV‐2 by RT-PCR on nasopharyngeal swabs. Of 21
breastfed neonates, two were admitted to the NICU for respiratory distress
syndrome and hemolytic anemia, respectively. No SARS‐CoV‐2 was detected
in placental tissue.
Neonates, care 21-May-20 Management of Journal of Review Article Management of neonates born to women with confirmed or suspected This paper provides Amatya S, Corr TE, Gandhi
practices, Newborns Perinatology COVID-19 is largely center-specific, given local customs and availability of guidance for CK, et al. Management of
mother- Exposed to resources. The authors of this report draw upon their limited experience and management of newborns exposed to
newborn Mothers With anecdotal reports from nearby institutions to develop a triage algorithm at newborns exposed to mothers with confirmed or
separation, Confirmed or the Penn State Hospital at Milton S. Hershey Medical Center that may be mothers with confirmed suspected COVID-19
36
breastfeeding, Suspected useful for other centers anticipating similar surges in cases of exposed or suspected COVID-19, [published online 2020 May
discharge, Penn COVID-19 newborns. Several care practices that have changed in the COVID-19 era are in the perinatal period. 21]. J Perinatol.
State, USA discussed including the use of antenatal steroids, delayed cord clamping, doi:10.1038/s41372-020-
mother-newborn separation, and breastfeeding in accordance with the 0695-0
recommendations of international organizations like the WHO. Moreover,
this paper provides guidance on the most suitable respiratory support for
newborns, as well as for the discharge process and beyond.
Pregnancy, 21-May-20 Detection of The Lancet Correspondence Recent investigations show no evidence for SARS-CoV-2 in human In this report Groß R, Conzelmann C,
breastfeeding, SARS-CoV-2 in breast milk, however sample sizes are small. In this report, authors (previously posted as a Müller JA, et al. Detection of
breast milk sam human analyzed milk samples from two nursing mothers who were diagnosed with preprint) of two nursing SARS-CoV-2 in human
ples, Germany breastmilk COVID-19 days after delivery of and room sharing, with each other and with mothers with COVID-19, breastmilk. Lancet.
their newborns. Following admission and delivery, four samples from both newborns tested doi:10.1016/S0140-
Mother 1 tested negative. By contrast, SARS-CoV-2 RNA was detected positive for SARS-CoV-2 6736(20)31181-8
in milk from Mother 2 at days 10, 12, and 13; samples taken subsequently infection within 1-2
were negative. Detection of viral RNA in Mother 2 coincided with mild weeks of birth. SARS-
COVID-19 symptoms and a SARS-CoV-2 positive diagnostic test of Newborn CoV-2 RNA was only
2. Mother 2 had been wearing a surgical mask since the onset of symptoms detected in one
and followed safety precautions when handling or feeding the neonate. mother's consecutive
Whether Newborn 2 was infected by breastfeeding or other modes of breast milk samples.
transmission remains unclear.
Preterm 21-May-20 Lack of Viral Journal of Letter to the This paper reports the case of a mother who presented with clinical In this case, a nursing Perrone S, Giordano
newborn, Transmission to Medical Editor symptoms of respiratory tract infection 11 days after the spontaneous mother was diagnosed M, Meoli A, et al. Lack of
breastfeeding, Preterm Virology delivery of a preterm female newborn (32 weeks + 2 days gestation). Since with COVID-19 11 days viral transmission to
breast milk sam Newborn From a birth, the newborn was both directly breastfed and fed expressed postpartum. At the preterm newborn from a
ple, expressed COVID-19 maternal milk; she also received Kangaroo Mother Care sessions. 11 days peak of symptoms, her COVID-19 positive
maternal milk, Positive after delivery, the mother tested positive for SARS-CoV-2 on RT-PCR of her breast milk sample breastfeeding mother at 11
Italy Breastfeeding nasopharyngeal swab. RT-PCR assay of her breast milk samples (pumped at tested negative for days postpartum [published
Mother at 11 the peak of maternal febrile symptoms) was negative for SARS-CoV-2 SARS-CoV-2 on RT-PCR, 2020 May 21]. J Med Virol.
Days allowing the continued provision of nutrition with expressed maternal milk. thus her newborn doi:10.1002/jmv.26037
Postpartum During hospital stay, the mother and healthcare providers followed hygiene continued to be fed
precautions, including wearing surgical masks, hand washing, and using with expressed
alcohol-based solutions to clean the surfaces. The neonate continued to maternal milk.
show normal vital parameters and was discharged. Breast milk contains
many components, including immunoglobulins, probiotic organisms, and
growth factors that support maturation of the infant's own immune system.
Pregnancy, 20-May-20 Management of Journal of Article During the COVID-19 pandemic, networking among maternity centers and This summary Pietrasanta C, Pugni L,
mother-infant the Mother- Neonatal and Commentary anticipatory planning is essential to organize assistance to mothers and addresses a number of Ronchi A, et al.
dyad, delivery, Infant Dyad With Perinatal neonates in maternity and neonatal wards. Early identification of SARS-CoV- aspects of mother- Management of the
NICU, Suspected or Medicine 2 infected mothers, before delivery, allows their management through infant dyad mother-infant dyad with
breastfeeding, Confirmed SARS- dedicated protocols and minimizes the risk of transmission for other patients management during suspected or confirmed
rooming-in, CoV-2 Infection and healthcare providers. Vertical transmission of SARS-CoV-2 cannot be SARS-CoV-2 epidemic. SARS-CoV-2 infection in a
Italy in a Highly excluded at present and should be ruled out as soon as possible after birth. highly epidemic context
Epidemic Rooming in of infected mothers and neonates, provided their good clinical [published online 2020 May
Context conditions, is not contraindicated based on current knowledge. The choice 20]. J Neonatal Perinatal
of breastfeeding should be carefully discussed with parents based on Med. doi:10.3233/NPM-
current, evolving scientific evidence. 200478
37
Pregnancy, 19-May-20 Skin-to-Skin Care Pediatrics Perspectives Current American Academy of Pediatrics (AAP) guidelines recommend The author argues in Boscia C. Skin-to-Skin Care
neonates, skin- and COVID-19 physical separation of COVID-19 positive women from their infants following favor of skin-to-skin and COVID-19 [published
to-skin contact, delivery, when space allows, unless they choose rooming-in despite being contact and online ahead of print, 2020
breastfeeding, counseled on risk. On the other hand, the WHO's recommendation breastfeeding over May 19]. Pediatrics. 2020.
perinatal encourage breastfeeding initiation within an hour of birth and routine recommendations to doi:10.1542/peds.2020-
outcomes newborn care with added emphasis on respiratory and hand hygiene. physical separate 1836
Neonates could be relatively protected from infection through COVID-19 positive
transplacental maternal IgG, and breastfeeding has known immune benefits mothers and newborns.
in other viral respiratory infections. The author argues that the benefits of
postpartum skin-to-skin contact, bonding, and breastfeeding outweigh
concerns about infection and the potential benefits of isolation. The most
commonly reported perinatal outcomes in this pandemic, for example
premature birth, could be mitigated through greater prenatal support for
pregnant women through social services.
Pregnancy, 19-May-20 Clinical Findings Obstetrics & Original Research This prospective multicenter cohort study includes 77 pregnant women with In this cohort, one in Savasi VM, Parisi F, Patanè
clinical and Disease Gynecology SARS-CoV-2 infection who were admitted to 12 Italian maternity hospitals five women hospitalized L, et al. Clinical Findings and
characteristics, Severity in between February 23 and March 28, 2020. Of 77 total women, 14 (18%) had with COVID-19 Disease Severity in
urgent delivery, Hospitalized severe disease. Two thirds of the patients in the cohort were admitted delivered urgently for Hospitalized Pregnant
preterm Pregnant during the third trimester, and 84% were symptomatic on admission. Eleven respiratory compromise Women With Coronavirus
delivery, Women With patients underwent urgent delivery for respiratory compromise (16%), and or were admitted to the Disease 2019 (COVID-19)
neonatal Coronavirus six were admitted to the ICU (8%). One woman received extracorporeal ICU. Four newborns [published online 2020 May
infection, Disease 2019 membrane oxygenation; no deaths occurred. Preterm delivery occurred in tested positive for 19]. Obstet Gynecol.
pregestational (COVID-19) 12% of patients, and nine newborns were admitted to the NICU. Four SARS-CoV-2 infection; doi:10.1097/AOG.00000000
BMII, Italy newborns (three vaginal deliveries, one cesarean delivery) of 57 were rooming-in and 00003979
diagnosed with SARS-CoV-2 infection in the early postpartum period. For all breastfeeding were
newborns, rooming-in and breastfeeding were performed. Patients in the performed.
severe subgroup had significantly higher pregestational body mass indexes
(BMIs) and heart and respiratory rates and a greater frequency of fever or
dyspnea on admission compared with women with a non-severe disease
evolution.
Pregnancy, 19-May-20 Near-term Journal of Original Article This cross-sectional survey presents analysis of prospectively collected data, This survey of attitude, Yassa M, Birol P, Yirmibes C,
knowledge, Pregnant Maternal at a single tertiary "Coronavirus Pandemic Hospital" referral center in concerns, and et al. Near-term pregnant
attitudes, Women's Fetal and Turkey, from non-SARS-CoV-2 infected women with a confirmed pregnancy knowledge of COVID-19 women's attitude toward,
concerns, Attitude Toward, Neonatal (>30 weeks' gestation). A total of 172 pregnant women (mean age 27.5 ± 5.3 among non-infected concern about and
breastfeeding Concern About Medicine years) were included. Overall, four women refused to participate to the pregnant women knowledge of the COVID-19
safety, Turkey and Knowledge survey (1.9%). Median gestational week and parity were 35 ± 11 weeks and revealed that most had pandemic [published online
of the COVID-19 1 ± 2, respectively. Pregnant women were observed to trust the authorities increased concerns and 2020 May 19]. J Matern
Pandemic (65%) and healthcare staff (92.4%), and their respect was increased (82.5%) limited knowledge of Fetal Neonatal Med.
during the outbreak. Most women (87.2%) comply with self-quarantine pregnancy-related doi:10.1080/14767058.2020
rules. Half of the women (52%) reported that they felt vulnerable, and 80% outcomes of COVID-19. .1763947
felt concerned. Approximately one-third of the women reported constantly Of note, half of women
thinking that they might get infected (35.5%) or they might get infected regarded breastfeeding
during/following delivery or their newborn might get infected after being to be safe during the
born (42%). Half of the women (50%) reported that they either had no idea pandemic.
about or thought that breastfeeding was not safe during the outbreak.
About 45% of women were confused or had doubts about whether or not
the COVID-19 pandemic would affect their mode of delivery. The majority of
38
women did not know if COVID-19 might cause birth defects (76%) or
preterm birth (64.5%). These findings may guide health care providers in
developing targeted messages to provide information to pregnant women.
Pregnancy, 19-May-20 Effects of Ultrasound Systematic A systematic review, conducted until April 20, 2020, identified a high Despite the increasing Juan J, Gil MM, Rong Z,
neonates, Coronavirus Obstetrics and Review number of case reports and case series on COVID-19 in pregnancy, but only number of published Zhang Y, Yang H, Poon LC.
perinatal Disease 2019 Gynecology 24 studies including a total of 324 pregnant women with COVID-19 were studies on COVID-19 in Effects of coronavirus
outcomes, (COVID-19) on included. These comprised 8 consecutive case series, 1 non-consecutive case pregnancy, there are disease 2019 (COVID-19) on
vertical Maternal, series, and 15 case reports. In the combined data from the 8 consecutive insufficient good-quality maternal, perinatal and
transmission, Perinatal and case series, which included 211/295 (71.5%) cases of laboratory-confirmed data to draw unbiased neonatal outcomes: a
breast milk sam Neonatal and 84/295 (28.5%) cases of clinically diagnosed COVID-19, the maternal age conclusions with regard systematic review
ples, systematic Outcomes: A ranged from 20 to 44 years and the gestational age on admission ranged to the severity of the [published online 2020 May
review Systematic from 5 to 41 weeks. The most common symptoms at presentation were disease or specific 19].
Review fever, cough, dyspnea/shortness of breath, fatigue and myalgia. The rate of complications of COVID- Ultrasound Obstet Gynecol.
severe pneumonia reported amongst the case series ranged from 0 to 14%, 19 in pregnant women, doi:10.1002/uog.22088
with the majority of cases requiring ICU admission. Almost all cases from the as well as vertical
case series had positive chest CT findings. The 6 and 22 cases that had transmission, perinatal
nucleic-acid testing in vaginal mucus and breast milk samples, respectively, and neonatal
were negative for SARS-CoV-2. Only 4 cases of spontaneous miscarriage or complications.
abortion were reported. 219/295 women had delivered at the time of
reporting (range 28-41 gestational weeks), and the majority of these had
Cesarean section. Apgar scores at 1 and 5 min ranged from 7 to 10 and 7 to
10, respectively. Only 8 neonates had birth weight <2500g, and nearly one-
third of cases were transferred to the NICU. There was 1 case each of
neonatal asphyxia and neonatal death. In 155 neonates that had nucleic-acid
testing in throat swabs, all but 3 cases were negative for SARS-CoV-2. In the
non-consecutive case series, describing 9 cases of severe COVID-19,
there were 7 maternal deaths, 4 intrauterine fetal deaths (1 with twin
pregnancy) and 2 neonatal deaths (twin pregnancy). In the case reports,
describing a total of 20 pregnant patients with COVID-19, 2 maternal deaths,
1 neonatal death and 2 cases of neonatal SARS-CoV-2 infection were
reported.
Preterm infant, 19-May-20 Horizontal The Lancet Case Report A male infant, born at 27 weeks' gestation, presented to the emergency This report presents the Cook J, Harman K, Zoica B,
ARDS, host transmission of Child & department (ED) at 8 weeks of age with a 2-day history of poor feeding, first detailed et al. Horizontal
inflammatory severe acute Adolescent sneezing, and dyspnea. 10 days before presentation, the infant had been description, to the transmission of severe
response, remd respiratory Health discharged from the neonatal unit after recovering from neonatal authors' knowledge, of acute respiratory syndrome
esivir, syndrome respiratory distress syndrome; he had been fed with maternal expressed a premature infant with coronavirus 2 to a
horizontal coronavirus 2 to breast milk from day 3 of life. There were no cases of COVID-19 on the severe SARS-CoV-2 premature infant: multiple
transmission, a premature neonatal unit before or following discharge, members of the infant's infection in whom organ injury and association
UK infant: multiple household (parents and a 4-year-old sibling) were asymptomatic, and there longitudinal assessment with markers of
organ injury and were no other reported contacts. On initial assessment in the ED, the infant of multiple organ injury, inflammation [published
association was in respiratory failure and presumed septic shock; resuscitation and blood online 2020 May 19]. Lancet
with markers of respiratory support were commenced. Quantitative RT-PCR showed that inflammatory markers, Child
inflammation the patient's nasopharyngeal swab sample was positive for SARS-CoV-2. A and viral & Adol Health. doi:10.1016/
blood culture was also positive for Staphylococcus epidermidis, at which load are described. S2352-4642(20)30166-8
point IV vancomycin was initiated as targeted treatment. The infant became
increasingly difficult to ventilate, and repeat chest X-rays showed worsening
bilateral airspace opacification consistent with acute respiratory distress
39
syndrome. Along with antimicrobial treatment, remdesivir was prescribed
on compassionate grounds and administered intravenously. Over the
following days, there was a gradual improvement in respiratory function,
and the infant was weaned from all respiratory support on day 24.
Respiratory improvement in this infant appeared to be associated with a
decrease in IL-6 concentration, ferritin, and lactate dehydrogenase, rather
than a decrease in viral load, suggesting that the host pulmonary
inflammatory response might have been important with regard to
respiratory failure.
Pregnancy, 18-May-20 Management of Journal of Other Articles At the time of writing, there have been no confirmed obstetric cases of These guidelines on Ezenwa BN, Fajolu IB, Akinaj
neonates, covid-19: A Maternal COVID-19 in Nigeria; the only confirmed case of COVID-19 in a child in obstetric and newborn o OR, et al. Management of
labor, obstetric Practical Fetal and Nigeria is a 6-week-old infant who returned from the UK with the mother. As management during the covid-19: a practical
management, Guideline for Neonatal the rate of obstetric cases will likely rise in Nigeria and other African COVID-19 pandemic are guideline for maternal and
breastfeeding, Maternal and Medicine countries, pregnant women will have to be attended to in facilities that are intended for use by newborn health care
Nigeria, sub- Newborn Health distinct from the COVID-19 isolation centers in the country. This guideline maternal and newborn providers in Sub-Saharan
Saharan Africa Care Providers in prepares and equips clinicians working in the maternal and newborn health care providers in sub- Africa [published online
Sub-Saharan care sectors in the sub-region to manage COVID-19 during pregnancy and Saharan Africa. 2020 May 18]. J Matern
Africa childbirth. With regard to breastfeeding, the authors note that the practice Fetal Neonatal Med.
to support, promote and protect breastfeeding should continue until there is doi:10.1080/14767058.2020
sufficient evidence to advise otherwise. They recommend that the frequency .1763948
of direct breastfeeding should be reduced to one to two times daily, and
other feeds should be expressed breast milk, fed orally in order to limit
mother-newborn contact and improve lactation.
Pregnancy, 18-May-20 SARS-CoV-2 in Journal of Review International perinatal societies and institutions have released guidelines for Recommendations for Narang K, Ibirogba ER,
neonates, Pregnancy: A Clinical the care of pregnant patients and their fetuses with COVID-19. This review the care of pregnant Elrefaei A, et al. SARS-CoV-2
perinatal Comprehensive Medicine summarizes these current guidelines in a comprehensive review for patients, patients and newborns in Pregnancy: A
society, Summary of healthcare workers, and healthcare institutions. 15 papers from 10 societies, with COVID-19 are Comprehensive Summary of
breastfeeding, Current through a literature search of society websites and their journal summarized from 10 Current Guidelines. J Clin
guidelines Guidelines publications, were included up until April 20, 2020. Recommendations international perinatal Med. 2020;9(5):E1521.
specific to antepartum, intrapartum, and postpartum care were abstracted societies. doi:10.3390/jcm9051521
from the publications and summarized in Tables. The summary of guidelines
for the management of COVID-19 in pregnancy across different societies is
fairly consistent, with some variation in the strength of recommendations.
Currently, there is no definitive evidence to suggest vertical transmission of
SARS-CoV-2, thus rooming-in and breastfeeding are still encouraged, unless
the mother is acutely ill.
Neonates, 18-May-20 COVID 19 in Journal of Review Article There is limited evidence to support the possibility of vertical transmission. This article summarizes Kallem VR, Sharma D.
pregnancy, Neonates Maternal Clinical presentation in neonates is nonspecific, commonly observed as current evidence on COVID 19 in neonates
clinical Fetal and temperature instability, respiratory distress, poor feeding, lethargy, vomiting clinical presentation of [published online 2020 May
presentation, Neonatal and diarrhea. A suspect case is defined as a neonate born to the mother with COVID-19 in neonates, 18]. J Matern Fetal Neonatal
breastfeeding, Medicine a history of 2019-nCoV infection between 14 days before delivery and as well as Med.
isolation 28 days after delivery, or as a neonate directly exposed to those infected recommendations for doi:10.1080/14767058.2020
with 2019-nCoV. The authors recommend that suspected COVID-19 positive delivery room and .1759542
mothers and their newborns should be kept together in a designated postnatal management
isolation room. Mothers can breastfeed their newborns with proper hand of neonates born to
and breast hygiene precautions. For confirmed COVID-19 positive mothers, suspected or confirmed
the authors recommend that neonates should be isolated immediately after
40
delivery, if facilities for isolation are available. In these cases, breastfeeding COVID-19 positive
can resume once the mother becomes asymptomatic and two consecutive mothers.
maternal swabs, separated by at least 24 hours, are negative.
Neonates, 17-May-20 Neonatal Cureus Case Report This report presents a case of neonatal infection in New York, USA. A 22-day- This report presents a Dumpa V, Kamity R, Vinci
pregnancy, Coronavirus old, previously healthy, full-term neonate was hospitalized after presenting mild case of neonatal AN, Noyola E, Noor A.
clinical 2019 (COVID-19) with a one-day history of fever and poor feeding. Routine neonatal sepsis SARS-CoV-2 infection Neonatal Coronavirus 2019
characteristics, Infection: A Case evaluation was negative. SARS-CoV-2 PCR testing was obtained, given and a review of (COVID-19) Infection: A
mild infection, Report and rampant community transmission, which returned positive. There were no published cases of Case Report and Review of
USA Review of other laboratory or radiographic abnormalities. The infant recovered neonatal COVID-19, Literature. Cureus.
Literature completely and was discharged home in two days once his feeding improved confirming observations 2020;12(5):e8165.
(the child was exclusively breastfed). The family was advised to self- of milder infection in Published 2020 May 17.
quarantine to prevent the transmission of COVID-19. The hypothesized this population. doi:10.7759/cureus.8165
mode of transmission was horizontal spread from his caregivers. This case
highlights the milder presentation of COVID-19 in otherwise healthy, full-
term neonates. COVID-19 must be considered in the evaluation of a febrile
infant. Infants and children may play an important role in the transmission of
COVID-19 in the community. This report also provides a review of 11
published cases of neonatal COVID-19 and their clinical characteristics.
Twin 16-May-20 Novel Case Reports Case Report A 39-year-old woman (gravida 1, para 0) presented at 27 weeks' gestation In this case of acute Mehta H, Ivanovic S, Cronin
pregnancy, coronavirus- in Women's with nasal congestion and dry cough for 7 days. Her physical examination respiratory distress A, et al. Novel coronavirus-
ARDS, related acute Health was benign, and laboratory studies were unremarkable. A PCR test was syndrome due to SARS- related acute respiratory
emergency respiratory positive for SARS-CoV-2, and a chest CT scan showed bilateral multi-focal CoV-2 in a pregnant distress syndrome in a
cesarean distress ground-glass opacities. A fetal non-stress test was reassuring. During her patient, oxygenation patient with twin
section, syndrome in a hospital stay, she developed progressively worsening respiratory failure that status dramatically pregnancy: A case report
premature patient with twin progressed to acute respiratory distress syndrome requiring mechanical improved after delivery [published online 2020 May
delivery, USA pregnancy: A ventilation. She then suffered from sudden hypoxemia and hemodynamic of twins; one twin 16]. Case Rep Women’s
case report collapse, on maximal ventilatory support, prompting an emergency cesarean tested positive for Health.
section at bedside, which led to rapid stabilization. Both of the twins were SARS-CoV-2 72h after doi:10.1016/j.crwh.2020.e0
born prematurely, and one tested positive for SARS-CoV-2. Following birth, birth. 0220
the twins were transferred to the NICU and were not breast fed.
Children, 15-May-20 Coronavirus Frontiers in Review Article This review summarizes current understanding of SARS-CoV-2 infection in A review of COVID-19 in Yu Y, Chen P. Coronavirus
neonates, Disease 2019 Pediatrics neonates and children from January 24 to May 1, 2020 using experience children and neonates, Disease 2019 (COVID-19) in
epidemiology, (COVID-19) in from China. Epidemiology, pathogenesis, diagnosis, and management of based primarily on Neonates and Children
pathogenesis, Neonates and COVID-19 in children and neonates are presented. Given that symptoms of Chinese experience and From China: A Review
diagnosis, Children From COVID-19 in children and neonates are atypical, and transmission within literature, is presented. [published online 2020 May
management, China: A Review family clusters is common, more effort should be made to protect this high- 15]. Front Pediatr.
breastfeeding, risk population. Although there is still no direct evidence of vertical doi:10.3389/fped.2020.002
China transmission, the authors argue that rescue of newborns of infected 87
pregnant women in delivery should not be delayed. The authors also
recommend avoiding breastfeeding if a pregnant woman or newborn is
diagnosed or suspected to have SARS-CoV-2 infection.
Pregnancy, 15-May-20 Is SARS-CoV-2 Frontiers in Review Article Few studies on the vertical transmission of SARS-CoV-2 are found in the This mini-review does Simões e Silva AC, Leal CRV.
neonatal Vertically Pediatrics literature. In all case reports and case series, the mothers' infection occurred not find convincing Is SARS-CoV-2 Vertically
infection, Transmitted? in the third trimester of pregnancy, there were no maternal deaths, and evidence of SARS-CoV-2 Transmitted? [published
vertical most neonates had a favorable clinical course. Viral RNA was not detected in vertical transmission in online 2020 May 15].
transmission neonatal nasopharyngeal swab samples at birth, in the placenta, in the existing literature. Front Pediatr.
umbilical cord, in the amniotic fluid, in the breast milk or in the maternal
41
vaginal swab samples in any of these articles. Only three papers reported doi:10.3389/fped.2020.002
neonatal SARS-CoV-2 infection, but there is a bias that positive pharyngeal 76
swab samples were collected at 36 hours and on the 2nd, 4th, and 17th days
of life (the possibility of nosocomial infection cannot be ruled out). The
possibility of intrauterine infection has been based mainly on the detection
of IgM and IL-6 in the neonates' serum. In conclusion, to date, no convincing
evidence has been found for vertical transmission of SARS-CoV-2.
Breastfeeding, 15-May-20 Speech Therapy, Codas Letter to Editor This report describes current evidence on potential SARS-CoV-2 transmission Breastfeeding Miranda VSG, Rech RS,
WHO Breastfeeding in breast milk, breastfeeding guidelines by major international organizations, guidelines by major Maahs MAP, Berbert MCB,
guidelines, and COVID-19: including the WHO, and infection control measures for human milk banks international Almeida ST. Speech therapy,
human milk ba Information to and donors. The Brazilian Society of Pediatrics has supported the organizations and breastfeeding and COVID-
nk, milk donors, Speech maintenance of breastfeeding in mothers with COVID-19, given the current recommendations for 19: information to speech
infection Therapist evidence. In addition, speech therapists have an active, positive role in the infection control therapist. Codas.
control, Brazil guidance for breastfeeding, thus should follow new recommendations. measures for 2020;32(3):e20200124.
human milk donation doi:10.1590/2317-
are summarized in this 1782/20192020124
report.
Pregnancy, 15-May-20 Expert Clinics (Sao Review Article This article presents expert recommendations for managing care of A consensus of experts Carvalho WB, Gibelli MABC,
neonates, Recommen- Paolo) newborns of mothers with suspected or diagnosed COVID-19. The consensus in Brazil developed Krebs VLJ, Calil VMLT,
NICU, expert dations for the was developed by five experts in neonatal intensive care working at a recommendations for Johnston C. Expert
guidelines, Care of reference university hospital in Brazil for the care of pregnant women and the care of newborns recommendations for the
Brazil Newborns newborns with COVID-19. Despite the lack of scientific evidence regarding born to mothers care of newborns of
of Mothers With the potential for vertical transmission, it is important to elaborate the with suspected or mothers with COVID-
COVID-19 lines of care by specialists from hospitals caring for COVID-19 cases to guide confirmed COVID-19. 19. Clinics (Sao Paulo).
multidisciplinary teams and families diagnosed with the disease or involved 2020;75:e1932.
in the care of pregnant women and newborns in this context. doi:10.6061/clinics/2020/e1
Recommendations for neonatal care consider personal protective 932
equipment and insulation precautions, assistance in the delivery room,
newborn transport and ICU admission, clinical evaluation of newborns,
breastfeeding (in support of breast milk expression), viral testing of
newborns, visitation to hospitalized newborns, hospital discharge, and home
isolation of mothers with COVID-19.
Pregnancy, 15-May-20 Impact of COVID- medRxiv Preprint This review identified all articles, without language limitation, on This review of articles Azarkish F, Janghorban R.
maternal and 19 infection on (not peer pregnancies affected by COVID-19, between October 2019 and Apr 30, 2020. on pregnancy and Impact of COVID-19
neonatal maternal and reviewed) Within 28 articles identified, data on 287 pregnant women with COVID-19 COVID-19 found infection on maternal and
outcomes, neonatal from 6 countries were assessed. Most pregnant women were in their third minimal adverse neonatal outcomes: a
cesarean outcomes: a trimester, and 102 (35.5%) cases were symptomatic at the time of maternal and neonatal review of 287 pregnancies
section, vertical review of 287 admission. Common onset symptoms, abnormal laboratory findings, and outcomes. Data are [published online 2020 May
transmission, pregnancies chest CT patterns were fever (51.5%), lymphocytopenia (67.9%), and limited on viral 15]. medRxiv.
breastfeeding multiple ground-glass opacities (78.5%) respectively. 93% of all deliveries transmission in utero, doi:10.1101/2020.05.09.200
were performed via cesarean section. No maternal mortality and 3 % ICU during vaginal childbirth 96842
admission were reported. Vertical transmission was not reported but its and breastfeeding, as
possibility was suggested in three neonates. One neonatal death, one well as the effects of
stillbirth, and one abortion were reported. In 60 cases, where newborn COVID-19 on first and
feeding was reported, all newborns were fed with formula. second trimester
pregnancies.
42
Pregnancy, 14-May-20 Delivery Room Pediatrics Review In this prospective study, all pregnant women admitted to labor and delivery The authors stress the Perlman J, Oxford C, Chang
newborn triage, Preparedness were tested by SARS-CoV-2 PCR, obtained from a nasopharyngeal swab, importance of C, Salvatore C, Di Pace J.
preterm birth, and Early between March 22 and April 15, 2020 at New York Presbyterian Weill Cornell awareness of the Delivery Room
delivery room Neonatal Medicine. Of 326 deliveries, 31 (9.5%) mothers tested positive for SARS-CoV- mother's SARS-CoV-2 Preparedness and Early
preparedness, Outcomes 2: 15 (48%) were asymptomatic, and 16 (52%) were symptomatic. All status and rapid Neonatal Outcomes During
New York, USA During COVID19 newborns initially triaged to the well-baby nursery (n=29) tested negative turnaround of testing in COVID19 Pandemic in New
Pandemic in New for SARS-CoV-2 and were breastfed and cared for in the mother's room. Two delivery room York City [published online
York City premature newborns were triaged to the NICU where they received preparedness. 2020 May 14]. Pediatrics.
continuous positive pressure ventilation, and after testing negative for SARS- doi:10.1542/peds.2020-
CoV-2, both were moved out of isolation. 1567
Neonatal care, 14-May-20 Caring for Pediatrics Commentary The uncertainty around neonatal SARS-CoV-2 infection risk has led to This report summarizes Gupta M, Zupancic JAF,
isolation, Newborns Born notable variations in care practices for newborns born to mothers with recommendations for Pursley DM. Caring for
breastfeeding, to Mothers With COVID-19. While there is some agreement, such as use of precautions for neonatal care, from Newborns Born to Mothers
recommendatio COVID-19: More delivery room resuscitation or isolation of exposed infants requiring national and with COVID-19: More
ns, WHO Questions Than intensive care, approaches to other aspects of care differ widely, including international Questions than Answers
Answers location of care and breastfeeding for term infants that are well and born to organizations, and [published online 2020 May
mothers without severe symptoms. Recommendations on these areas from outlines areas for 14]. Pediatrics.
several national-level organizations, as well as the WHO, are summarized in further research. doi:10.1542/peds.2020-
this report. Critical and time-sensitive needs for research around neonatal 001842
care and outcomes are also outlined: (1) larger sample sizes reflecting
diverse populations; (2) descriptions of care practices with ability to assess
comparative effectiveness of different approaches; (3) follow-up information
on maternal and neonatal outcomes after birth hospitalization.
Neonates, NICU 14-May-20 Neonatal Current Full Length There are limited data on the effect of COVID-19 in fetal life, and among This article consolidates Verma S, Lumba R, Lighter
preparedness, Intensive Care Problems in Article neonates after birth. Therefore, there is an urgent need for proactive guidance on NICU JL, et al. Neonatal Intensive
CDC, New York Unit Pediatric and preparation to combat COVID-19 and safeguard patients, families, and preparedness for the Care Unit Preparedness for
City Preparedness for Adolescent healthcare personnel. This review article is based on the Centers for Disease COVID-19 pandemic, the Novel Coronavirus
the Novel Health Care Control and Prevention's (CDC) current recommendations for COVID-19 and based on CDC Disease-2019 Pandemic: A
Coronavirus its adaptation to local resources at a hospital in New York City. This article recommendations and New York City Hospital
Disease-2019 aims to provide basic consolidated guidance and checklists for clinicians in experience at a New Perspective [published
Pandemic: A neonatal intensive care units. Recommendations consider risk of vertical York City hospital. online 2020 May 14]. Curr
New York City transmission, preparation before delivery, preparation in the delivery room, Probl Pediatr Adolesc
Hospital newborn transport, mother and newborn contact, NICU care, horizontal Health Care.
Perspective transmission to newborns, breastfeeding, communication with caregivers, doi:10.1016/j.cppeds.2020.
and hospital discharge. 100795
Pregnancy, 14-May-20 Improving the The Journal of Review Article A systematic review of electronic databases identified 29 papers on This systematic review Abdollahpour S,
childbirth, Quality of Care in Maternal- pregnancy and COVID-19, published in English, prior to March 25, 2020. The aims to improve quality Khadivzadeh T. Improving
neonates, Pregnancy and Fetal & results of the review of existing literature are presented in the following nine of care during the quality of care in
quality of care, Childbirth With Neonatal sections: Symptoms of the COVID-19 in pregnancy, Pregnancy management, pregnancy and pregnancy and childbirth
systematic Coronavirus Medicine Delivery Management, Mode of delivery, Recommendations for health care childbirth for mothers with coronavirus (COVID-
review (COVID-19): A provider in delivery, Neonatal outcomes, Neonatal care, Vertical and newborns with 19): a systematic review
Systematic Transmission, and Breastfeeding. The authors conclude that improving COVID-19. [published online 2020 May
Review quality of care in maternal health, as well as educating, training, and 14]. J Matern Fetal Neonatal
supporting healthcare providers in infection management, must be Med.
prioritized. doi:10.1080/14767058.2020
.1759540
43
Pregnancy, 14-May-20 Probable Canadian Original Article A 40-year-old woman (gravida 2, para 1) was admitted to a tertiary hospital This case presents Kirtsman M, Diambomba Y,
neonatal Congenital SARS- Medical in Toronto, Ontario with history of gestational diabetes and frequent evidence of possible Poutanen SM, et al.
infection, CoV-2 Infection Association bacterial infections. The patient presented with myalgia, decreased appetite, congenital transmission Probable congenital SARS-
vertical in a Neonate Journal fatigue, dry cough, and fever. A nasopharyngeal swab was positive for SARS- of SARS-CoV-2, with CoV-2 infection in a neonate
transmission, Born to a CoV-2 via RT-PCR testing. The woman did not need any respiratory support positive placental and born to a woman with
placental Woman With at the time of birth. A semi-urgent cesarean delivery was performed owing breast milk findings active SARS-CoV-2 infection
pathology, Active SARS-CoV- to worsening coagulopathy and reducing platelet count. Delayed described. The mother [published online 2020 May
Canada 2 Infection cord clamping was not performed, and the neonate was immediately and newborn did not 14]. CMAJ.
separated. All 3 nasopharyngeal swabs, obtained from the neonate on the suffer doi:10.1503/cmaj.200821
day of birth, day 2, and day 7 were positive for SARS-CoV-2; neonatal plasma any complications from
tested positive on day 4, and stool was positive on day 7. At 36 hours of age, COVID-19.
repeated episodes of hypoglycemia and feeding difficulties necessitated the
newborn's admission to the NICU. He was transferred back to his mother's
room, and both were discharged home on day 4 after birth. On
histopathologic examination, the placenta showed multiple areas of
infiltration by inflammatory cells, consistent with chronic
histiocytic intervillositis, and extensive early infarction. Placental swabs
(both maternal and fetal sides) and breast milk also tested positive for SARS-
CoV-2. The authors stated that the potential for respiratory secretion
contamination of breast milk cannot be ruled out but was minimized by
breast hygiene and cleaning before specimen collection.
Infants, febrile, 13-May-20 A Case Series of Pediatrics Case Report This case report describes three febrile infants, less than two months of age, To the authors' Feld L, Belfer J, Kabra R, et
feeding the 2019 Novel admitted to a large, tertiary care children's hospital in New York and knowledge, this report al. A Case Series of the 2019
difficulty, New Coronavirus subsequently found to be infected with SARS-CoV-2. All three patients describes three of the Novel Coronavirus (SARS-
York (SARS-CoV-2) in presented with fever, feeding difficulty, lymphopenia, and thrombocytosis youngest patients to be CoV-2) in Three Febrile
Three Febrile on laboratory evaluation. Two of the three patients were found to have reported with SARS- Infants in New York
Infants in New neutropenia and two had known exposures to sick contacts. All patients had CoV-2 in the United [published online, 2020 May
York unremarkable hospital courses; two required intravenous fluid support due States. 13]. Pediatrics.
to poor feeding. All were discharged without complications. doi:10.1542/peds.2020-
1056
Breastfeeding, 12-May-20 WHO Frequently Journal of Clinical The World Health Organization has published new responses to frequently The WHO developed WHO Frequently Asked
transmission Asked Questions: Human Recommendatio asked questions regarding COVID-19 and breastfeeding to help providers responses to frequently Questions : Breastfeeding
risk, WHO, Breastfeeding Lactation ns counsel mothers and families. The key messages include the following: I. asked questions and COVID-19 For health
maternal and COVID-19 Breastfeeding and skin-to-skin contact significantly reduce the risk of death regarding breastfeeding care workers. J Hum Lact.
counselling For health care in newborns and young infants and provide immediate and lifelong health and COVID-19 and 2020;36(3):392-396.
workers and development advantages. Breastfeeding also reduces the risk of breast concludes that the doi:10.1177/089033442093
and ovarian cancer for the mother. II. Newborns and infants are at low risk benefits of 9556
of COVID-19 infection. Among the few cases of confirmed COVID-19 breastfeeding outweigh
infection in young children, most have experienced only mild or the potential risks of
asymptomatic illness. III. The numerous benefits of breastfeeding transmission to the
substantially outweigh the potential risks of transmission and illness newborn.
associated with COVID-19. IV. Active COVID-19 has not been detected in the
breastmilk of any mother with confirmed/suspected COVID-19 and there is
no evidence so far that the virus is transmitted through breastfeeding.
44
Pregnancy, 11-May-20 Vaginal Delivery European Correspondence On March 17, 2020, a Caucasian 31-year-old woman with 38 weeks’ This case describes an Polónia-Valente R, Moucho
neonate, in a Woman Journal of gestation was admitted to hospital in Porto, Portugal, complaining of mild uncomplicated vaginal M, Tavares M, Vilan A,
vaginal Infected With Obstetrics & painful uterine contractions for a few hours. Since her husband had been delivery, with Montenegro N, Rodrigues T.
delivery, fetal SARS-CoV-2 - The Gynecology diagnosed with COVID-19 and hospitalized on March 12, she was treated as continuous electronic Vaginal delivery in a woman
monitoring, First Case and a suspected case upon admission. SARS-CoV-2 was detected by RT-PCR fetal monitoring, in a infected with SARS-CoV-2 -
mechanical Reported in Reproductive analysis on nasal and oropharyngeal swabs. Following an operative vaginal woman with COVID-19 The first case reported in
breast Portugal Biology delivery, with fetal vacuum extraction, the umbilical cord was immediately without severe disease; Portugal [published online
stimulation, clamped without neonate-maternal contact. The newborn was separated the neonate tested 2020 May 11]. Eur J Obstet
Portugal from the mother immediately after birth, and repeated newborn nasal and negative for SARS-CoV- Gynecol Reprod Biol.
oropharyngeal RT-PCR tests were negative for SARS-CoV-2. Symptomless, 2. doi:10.1016/j.ejogrb.2020.0
the mother was discharged first and began mechanical breast stimulation, in 5.007
order to breastfeed soon after her COVID-19 recovery.
Late pregnancy, 11-May-20 Report of a Acta Correspondence/ This case series reports four neonates whose mothers had recovered from Findings from this series Perrone S, Deolmi M,
neonates, Series of Healthy Biomedica Case Reports COVID-19 (RT-PCR assays on nasopharyngeal swabs turned negative). All indicate that adverse Giordano M, et al. Report of
convalescent Term Newborns four women were diagnosed in the third trimester of pregnancy at Parma effects on fetuses from a series of healthy term
mothers, Italy From Hospital, Italy in March and April 2020. All neonates were delivered (3 pregnancies newborns from
Convalescent vaginal delivery, 1 elective cesarean section) at term in good conditions complicated by COVID- convalescent mothers with
Mothers With without evidence of congenital COVID-19 infection on nasopharyngeal 19; four healthy COVID-19. Acta Biomed.
COVID-19 swabs, and all were breastfed. neonates were born to 2020;91(2):251‐255.
(only abstract mothers recovering Published 2020 May 11.
available when from SARS-CoV-2 doi:10.23750/abm.v91i2.97
posted on May infection in the third 43
22, 2020) trimester of pregnancy.
Postnatal care, 11-May-20 Post-natal Journal of Guidelines The French National Authority for Health (HAS) sets forward general The French National Vivanti AJ, Deruelle P,
neonates, Follow-Up for Gynecology recommendations designed to ensure continuity of care for pregnant Authority for Health Picone O, et al. Post-natal
lockdown, Women and Obstetrics and women during lockdown. Rapid responses were developed based on sets recommendations follow-up for women and
breastfeeding, Neonates During Human interviews with expert organizations and available knowledge at the time of for follow-up postnatal neonates during the COVID-
France the COVID-19 Reproduction their publication. Topics discussed include discharge after childbirth, care for mothers and 19 pandemic: French
Pandemic: anticipating possible infection of the newborn, adapting postnatal follow-up newborns during National Authority for
French National at home, maternal and child monitoring parameters, surveillance in the case lockdown, with specific Health recommendations
Authority for of early discharge (before 48h after childbirth), neonatal screening tests, considerations for [published online 2020 May
Health support for private practice care, and specific considerations for COVID COVID positive dyads. 11]. J Gynecol Obstet Hum
Recommen- positive mothers and newborns. The HAS supports breastfeeding in the case Reprod.
dations of COVID positive mothers, with proper hygiene precautions. doi:10.1016/j.jogoh.2020.10
1805
Pregnancy, 10-May-20 COVID-19 and Journal of Review Currently, there is no evidence that pregnant women are more susceptible Current evidence on Rajewska A, Mikołajek-
neonates, Pregnancy - Perinatal to SARS-CoV-2 infection than the general population. Premature rupture of COVID-19 in pregnancy, Bedner W, Lebdowicz-
maternal Where Are We Medicine membranes, premature labor and fetal distress have been observed in neonatal outcomes, and Knul J, Sokołowska M,
outcomes, Now? A Review women with COVID-19 in their third trimester. There are no data on breastfeeding are Kwiatkowski S, Torbé A.
delivery, complications of SARS-CoV-2 infection before the third trimester. COVID-19 reviewed. COVID-19 and pregnancy -
vertical infection should not be the only indication for delivery but can indicate where are we now? A
transmission, surgical delivery if necessary to improve maternal oxygenation; decision on review [published online
breastfeeding delivery mode should be individualized. Vertical transmission of SARS-CoV-2 2020 May 10]. J Perinat
from the pregnant woman to the fetus has not been proven. As the virus is Med. doi:10.1515/jpm-
absent in breast milk, the experts encourage breastfeeding for neonatal 2020-0132
acquisition of protective antibodies.
45
Infant, 10-May-20 Novel Indian Clinical Case A 4-month-old infant presented with a 4-day history of high-grade fever and This case of Kawasaki- Acharyya BC, Acharyya S,
Kawasaki Coronavirus Pediatrics Letter developed an erythematous macular rash over the trunk, palm and sole on like disease is a novel Das D. Novel Coronavirus
Disease, CRP, Mimicking the second day. On admission, the child was hemodynamically stable and presentation among Mimicking Kawasaki Disease
IVIG, India Kawasaki Disease breastfeeding normally but had red lips, congested throat, and small cervical young children in India, in an Infant [published
in an Infant lymphadenopathy. Antibiotic therapy was initiated, but fever continued until still in the early stage of online 2020 May 22]. Indian
the third day when he developed non-purulent conjunctivitis with left the pandemic. Pediatr.
subconjunctival hemorrhage. Fever subsided 24 hours after IV S097475591600184.
immunoglobulin therapy was started, following when his SARS-CoV-2 RT-PCR
test revealed a positive result. Over the course of hospitalization, a rise of C-
reactive protein was observed without any neutrophilia, lymphopenia, or
organ dysfunction.
Breastfeeding, 10-May-20 The Importance The Journal of Editorial This commentary draws upon a statement and recommendations recently This editorial draws Williams J, Namazova-
breast milk, of Continuing Pediatrics issued by the Regional Office for Europe of the WHO with the contribution of upon WHO Baranova L, Weber M, et al.
immune system Breastfeeding main European pediatric organizations. According to the WHO, mothers with recommendations to The importance of
development, During COVID- suspected or confirmed COVID-19 can breastfeed their newborns as long provide guidance in continuing breastfeeding
WHO 19: In Support to as they take appropriate precautions. Breast milk encloses various support of during COVID-19: in support
the WHO antimicrobial substances, anti-inflammatory components and factors that breastfeeding and to the WHO statement on
Statement on promote the development of the immune system and reduce the occurrence related safety measures breastfeeding during the
Breastfeeding of respiratory tract infections. There is no evidence to date to suggest the during the COVID-19 pandemic [published online
During the novel coronavirus can pass to infants through breast milk, although the pandemic 2020 May 10].
Pandemic possibility cannot be ruled out. J Pediatr. doi:10.1016/j.jped
s.2020.05.009
Nutritional 10-May-20 COVID-19 Current Topics Editorial The persisting COVID-19 pandemic will have long-lasting effects on the This editorial highlights Kumar Y, Jain A. COVID-19
status, food Pandemic - Are in Medicinal masses i.e. on nutritional status, health, economies and the global food concerns related to and Pandemic - Are We Heading
insecurity, We Heading Chemistry chain. Necessary steps to maintain and promote healthy nutritional status potential strategies to From Health Crisis Towards
routine From Health include effective integration of nutrition-supportive measures into COVID-19 mitigate the growing An Unprecedented
nutrition Crisis Towards action plans, while safeguarding prevailing nutrition programs, particularly nutritional crisis due to Nutrition Crisis? [published
services, An for vulnerable populations (children, pregnant women, and the elderly). In the food insecurity and online 2020 May 10]. Curr
micronutrient Unprecedented addition, awareness must be generated through mobile phone surveys and disruptions in routine Top Med Chem.
supplementa- Nutrition Crisis? nutrition counselling through media, regarding the importance of high- service delivery caused doi:10.2174/156802662099
tion, vulnerable quality diets, appropriate infant and young child feeding practices, optimal by the COVID-19 9200511092629
populations breastfeeding techniques, and dietary diversity. Keeping in mind the pandemic, particularly
predictable upsurge in malnutrition, due to food insecurity and diversion of for vulnerable
healthcare resources away from nutrition programs and towards COVID-19, populations.
it is important to provide timely screening, referral services, and
micronutrient supplements to vulnerable populations.
Pregnancy, 8-May-20 Can SARS-CoV-2- Journal of Correspondence It is unclear whether breastfeeding transmits SARS-CoV-2 virus from Repeated RT-PCR Lang GJ, Zhao H. Can SARS-
breastfeeding, infected women Zhejiang previously infected and recovered mothers to their newborns. This report analyses of CoV-2-infected women
breast milk sam breastfeed after University- presents the clinical course of a pregnant woman (35 weeks and 2 days of breast milk samples in a breastfeed after
ples, viral viral clearance? SCIENCE B gestation at admission) with COVID-19 and viral RNA measurements in the postpartum mother viral clearance?. J Zhejiang
clearance, patient's breastmilk samples at different time points after delivery. At with COVID-19 were Univ Sci B. 2020;21(5):405‐
China delivery, RT-PCR tests of maternal serum, urine, stool, cord blood, amniotic consistently negative, 407.
fluid, and placenta were negative for SARS-CoV-2. An oropharyngeal swab contributing to growing doi:10.1631/jzus.B2000095
from the newborn was obtained immediately after birth and was negative. evidence that SARS-
The newborn was isolated and subsequent oropharyngeal swabs, blood, CoV-
stool, and urine remained negative. Beginning on day 4 of hospitalization, 2 is not transmitted
repeated RT-PCR analyses of the mother's sputum and breastmilk were through breast milk.
46
consistently negative for SARS-CoV-2 viral RNA. The authors conclude that
breastfeeding can be practiced after an isolation period is completed and
repeat testing is normal. In the meantime, breast pumping is recommended
to preserve benefits of human milk for newborns and mothers.
Children, 8-May-20 Characterisation Journal of Review Article This systematic review and meta-analysis analyze articles on pediatric cases This systematic review Mustafa NM, A Selim
neonatal of COVID-19 Clinical of COVID-19, published up to April 2, 2020 in PubMed and Google Scholar. evaluates literature on L. Characterisation of
infection, Pandemic in Virology Of 251 children (median age: 6.5 years, range: 0-12 years) reported in 11 COVID-19 in children COVID-19 Pandemic
clinical Paediatric Age studies, the most frequently reported symptoms were cough (49%, 95% CI: and reports of neonatal in Paediatric Age Group: A
characteristics, Group: A 42 - 55%) and fever (47%, 95% CI: 41- 53%). Lymphopenia and elevated outcomes to analyze Systematic Review and
vertical Systematic Procalcitonin levels were recorded in 17 cases (21%, 95% CI: 12 - 30%) and disease characterization Meta-Analysis [published
transmission, Review and 22 cases (28%, 95% CI: 18 - 37%) respectively. The case fatality rate was 0%. in the pediatric age online 2020 May 8]. J
systematic Meta-Analysis In addition, from 6 studies reviewed to determine vertical transmission risk, group including the Clin Virol. doi:10.1016/j.jcv.
review 4/58 neonates (6.8%) born to COVID-19 confirmed mothers tested positive possibility of vertical 2020.104395
on various samples for the disease. The affected neonates were all males transmission.
and delivered by cesarean section. One neonate, who tested negative for
SARS-CoV-2, died from multiorgan failure and disseminated intravascular
coagulation. All samples of breast milk, amniotic fluid, cord blood, placenta,
and vaginal swab in this review tested negative for SARS-CoV-2.
Pregnancy, 8-May-20 Should Infants Breastfeeding President's The World Health Organization (WHO) recommends that infants and This article presents Stuebe A. Should Infants Be
neonates, Be Separated Medicine Corner mothers with suspected or confirmed COVID-19 “should be enabled to potential risks of Separated from Mothers
temporary from Mothers remain together and practice skin-to-skin contact...” Breastfeeding is temporary separation with COVID-19? First, Do No
separation, skin with COVID- strongly recommended. In contrast, the U.S. Centers for Disease Control of infants and Harm. Breastfeed
-to-skin 19? First, Do No and Prevention (CDC) advises that facilities “consider temporarily separating mothers with COVID-19, Med. 2020;15(5):351‐
contact, Harm the mother from her infant” until the mother is no longer considered as advised by the U.S. 352. doi:10.1089/bfm.2020.
breastfeeding contagious. During separation, women may express breast milk to be fed to CDC. 29153.ams
the newborn by a healthy caregiver. This article considers the following risks
of temporary separation. 1) Separation may not prevent infection. 2)
Interruption of skin-to-skin care disrupts newborn physiology. 3) Separation
stresses mothers.4) Separation interferes with provision of maternal milk to
the infant, disrupting immune protection. 5) Disruptions in breastfeeding
increase the risk of infant hospitalization for pneumonia. 6) Separate
isolation doubles the burden on the health system.
Human milk, 8-May-20 Evidence of a medRxiv Preprint The extent of the human milk immune response to SARS-CoV-2 is unknown. These data indicate that Fox A, Marino J, Amanat F,
immune significant (not peer This response is critical for infants and young children, who experience mild there is strong sIgA- et al. Evidence of a
response, secretory-IgA- reviewed) COVID-19 disease but are likely responsible for significant virus transmission. dominant SARS-CoV-2 significant secretory-IgA-
secretory IgA dominant SARS- Perhaps even more significant is the fact that milk anti-bodies (Abs) could be immune response in dominant SARS-CoV-2
antibodies CoV-2 immune purified and used as a COVID-19 therapeutic, given they would likely be of human milk after immune response in
response in the secretory (s) class and highly resistant to proteolytic degradation in infection. human milk following
human milk follo respiratory tissue. In this preliminary report, 15 milk samples obtained from recovery from COVID-19
wing recovery donors previously-infected with SARS-CoV-2, as well as 10 negative control [published online 2020 May
from COVID-19 samples obtained pre-pandemic, were tested for reactivity to the Receptor 8]. medRxiv.
Binding Domain of the SARS-CoV-2 Spike protein by ELISA assays measuring doi:10.1101/2020.05.04.200
IgA, IgG, IgM, and secretory Ab. 80% of samples obtained post-pandemic 89995
exhibited IgA reactivity, and all these samples were also positive for
secretory Ab reactivity, suggesting the IgA is predominantly sIgA. COVID-19
group mean optical density (OD) values of undiluted milk were significantly
47
greater for IgA (p<0.0001), secretory-type Abs (p<0.0001), and IgG (p=0.017),
but not for IgM, compared to pre-pandemic group mean values.
Pregnancy, 7-May-20 COVID-19 in a Lancet Child & Case Report An extremely preterm female neonate (26 gestational weeks + 4 days) was This case study Piersigilli F, Carkeek
preterm 26-week preterm Adolescent born at a tertiary level hospital in Brussels, Belgium, on March 1, 2020. The describes an extremely K, Hocq C,
neonate, neonate Health mother had been referred from a peripheral hospital for pre-eclampsia and preterm neonate, born van Grambezen B, Hubinont
breast milk sam suspected cholecystitis. During hospitalization, the mother developed HELLP to a mother with C, Chatzis O et al. COVID-19
ple, Belgium (hemolysis, elevated liver enzymes, and low platelet count) syndrome and COVID-19. Both were in a 26-week preterm
intramuscular corticosteroids were administered for fetal pulmonary diagnosed with SARS- neonate [published online
maturation. The neonate was delivered by cesarean section 48 hours later CoV-2 following delivery 2020 May 7]. Lancet Child
and transferred to the NICU, where she received non-invasive intermittent and remained clinically & Adol Health.
positive pressure ventilation and surfactant therapy. Despite a stable. A maternal doi:10.1016/S2352-
pneumothorax requiring drainage, the neonate remained stable in a closed breast milk sample 4642(20)30140-1
incubator throughout her admission. On day 6 after delivery, the mother's tested negative for
nasopharyngeal swab tested positive for SARS-CoV-2, and the neonate SARS-CoV-2 RNA.
tested positive the following day. Prior to the mother's diagnosis, the
neonate had received maternal expressed breast milk, which had tested
negative for SARS-CoV-2. RT-PCR testing of the neonate's nasopharyngeal
swab was positive 7 days after the initial positive test and tested negative
after 14 days; the mother tested negative only after 21 days.
Neonatal 6-May-20 Maintaining The Lancet Comment A Virtual Communication Network of milk bank leaders formed on March 17, A Virtual Shenker N, on behalf of the
nutrition, safety and Child & 2020, and now has more than 80 members from 34 countries. Data collated Communication Virtual Collaborative
breastfeeding, service provision Adolescent from regional and country leads show that more than 800,000 infants are Network of Network of
human milk ba in Health estimated to receive donor milk worldwide annually. The group actively international milk bank Human Milk Banks and
nking human milk bank discusses COVID-19-specific challenges and has developed mitigation leaders considers issues Associations. Maintaining
ing: a call to strategies to ensure donor milk safety and service continuation, which will related to the provision safety and service provision
action in shortly be made available as a publication. Unlike HIV, where transmission of donor milk services in human milk banking: a
response to the via breastfeeding was a source of infection, there is no evidence to support during the COVID-19 call to action in response to
COVID-19 SARS-CoV-2 transmission from human milk, and the virus is inactivated by pandemic and provides the COVID-19 pandemic
pandemic heat treatment. In line with WHO recommendations, the promotion of guidance around [published online 2020 May
breastfeeding and a human milk diet, using donor milk bank resources, must breastfeeding. 6]. Lancet Child
be prioritized as an essential component of early newborn care. & Adol Health.
doi:10.1016/S2352-
4642(20)30134-6
Infants, 6-May-20 COVID-19 in The Pediatric Brief Report This case series reports on 8/70 (11.4%) SARS-CoV-2 positive infants (range: In this case series of Ng KF, Bandi S, Bird PW,
neonates, Neonates and Infectious 5 days-12 months), who were tested between March 10 and April 17, 2020. neonates and infants, Wei-Tze Tang J. COVID-19 in
preterm Infants: Diseases 5/8 (63%) developed fever, 4/8 (50%) had lower respiratory tract cases of COVID-19 Neonates and Infants:
delivery, Progression and Journal involvement, 2/8 (25%) had neutropenia and thrombocytosis, and 4/8 ranged from Progression and Recovery
pediatric Recovery infants (50%) were treated for suspected sepsis with broad-spectrum asymptomatic to [published online, 2020 May
intensive care, antibiotics. Only 1/8 (13%) required pediatric intensive care following moderately severe; all 6]. Pediatr Infect Dis J. 2020.
UK premature delivery at 34 weeks' gestation; the neonate was still able to be recovered quickly and doi:10.1097/INF.000000000
breastfed after delivery. All patients were eventually discharged. were asymptomatic by 0002738
discharge.
Newborn, 6-May-20 Newborns at Risk Journal of Editorial Newborns can be infected with SARS-CoV-2, and transmission is thought to Post-natal transmission Shah MD, Saugstad OD.
neonate, of COVID-19 Perinatal primarily occur postnatally. Guidelines for the care of COVID-19-positive or of SARS-CoV-2 can lead Newborns at risk of COVID-
postnatal Medicine suspected-positive mother-infant duos in the immediate post-natal period to neonatal infections 19. [published online, 2020
transmission, have been put forth, but there are differences in the proposed approaches. of COVID-19. Different May 6]. J Perinat Med.
breastfeeding The authors discuss the strategies recommended by China, the European guidelines have been doi:10.1515/jpm-2020-0170
48
Society/WHO, and the CDC/American Academy of Pediatrics in the USA. proposed for the care of
They then describe the pros and cons of these different approaches. They these mothers/infants;
also present emerging data about asymptomatic or mildly symptomatic however, global
mothers who become severely ill after delivery. In conclusion, the authors research is needed to
state that global collaborative research efforts are needed to fully understand the
understand the implications of the diverse approaches to handling newborns outcomes of these
at risk of COVID-19. various approaches.
Pregnancy, 5-May-20 Coronavirus BJOG Case Series In this single center cohort study, 13 pregnant women with SARS-CoV-2 Negative SARS-CoV-2 Wu Y, Liu C, Dong L, et al.
breast milk sam Disease 2019 infection, diagnosed between January 31 and March 9, 2020 at Renmin test results for vaginal Coronavirus disease 2019
ples, vaginal Among Pregnant Hospital, Wuhan, China, were included. Of the 13 women, 5 were in their secretion specimens, among pregnant Chinese
secretions, Chinese Women: first trimester, 3 in their second trimester, and 5 in their third trimester. Of from pregnant women women: Case series data on
China Case Series Data the 5 women during their third trimester who gave birth, all delivered live with COVID-19, suggest the safety of vaginal birth
on the Safety of newborns. Among these 5 deliveries, the primary adverse perinatal that vaginal delivery and breastfeeding
Vaginal Birth and outcomes included premature delivery (n = 2) and neonatal pneumonia (n = may be a safe option. [published online, 2020 May
Breastfeeding 2). One of 9 maternal stool samples was positive for SARS-CoV-2 on RT-PCR; However, a positive 5]. BJOG. 2020.
all 13 vaginal secretion samples in addition to 5 neonatal throat swabs and 4 breast milk sample in doi:10.1111/1471-
neonatal anal swabs were negative. However, 1 of 3 samples of this 0528.16276
breast milk was positive by viral nucleic acid testing. study warrants further
study of the risk for viral
contamination.
Neonatal 4-May-20 Early Neonatal Pediatrics Case Report On the second day after uncomplicated vaginal delivery of a male neonate, A case of COVID-19 in a Sinelli MT, Paterlini G, Citter
infection, SARS-CoV-2 the mother developed fever without respiratory symptoms, and her 3-day-old io M, Di Marco A, Fedeli T,
hypoxemia, Infection nasopharyngeal swab was positive for SARS-CoV-2. A nasopharyngeal swab neonate manifested Ventura ML. Early Neonatal
perioral Manifesting With obtained on the same day was also positive for the neonate, who was with silent hypoxemia. SARS-CoV-2 Infection
cyanosis, poor Hypoxemia isolated from his mother. After 48 hours of isolation, on day 5 of life, the The neonate was fed Manifesting With Hypoxemi
sucking, Requiring neonate developed perioral cyanosis and poor sucking without signs of expressed a Requiring Respiratory
maternal Respiratory respiratory distress. Arterial blood gas analysis demonstrated moderate maternal milk via nasog Support [published online,
expressed milk, Support hypoxia. The neonate was admitted to the NICU and placed on 30% inspired astric tube until he was 2020 May 4]. Pediatrics.
Italy oxygen via high-flow nasal cannula, and his condition improved. He was fed able to 2020.
maternal expressed milk by nasogastric tube for 48 hours, after which he be fed orally. The doi:10.1542/peds.2020-
was able to be fully fed orally. On days 15 and 21 of life, his qualitative PCR nasopharyngeal swab 1121
for COVID-19 remained positive. remained positive for
more than two weeks,
unlike previous reports
showing rapid virologic
clearance.
Vertical 3-May-20 Evidence for and American Review (journal Twelve articles, published between February 10 and April 4, 2020, reporting This review discusses Lamouroux A, Attie-
transmission, Against Vertical Journal of pre-proof) on 68 cases of maternal infection in the third trimester of pregnancy and published literature to Bitach T, Martinovic
congenital vs. Transmission for Obstetrics and deliveries of 71 neonates were identified. In these studies, SARS-CoV-2 viral date that support or J, Leruez-Ville M, Ville
perinatal SARS-CoV-2 Gynecology nucleic acid was recovered by RT-PCR from nasal/throat swabs, sputum and refute the possibility of Y. Evidence for and against
transmission, (COVID-19) feces of symptomatic patients, including neonates, but not from maternal vertical transmission, vertical transmission for
placenta, vaginal swabs, amniotic fluid, placenta, cord blood, neonatal blood or both congenital and SARS-CoV-2 (COVID-19)
breast milk sam breast milk samples. Understanding perinatal exposure, influenced by mode perinatal, of SARS-CoV- [published online, 2020 May
ples, maternal of delivery (e.g. exposure to maternal feces during vaginal delivery) and time 2 infection. 3]. Am J Obstet Gynecol.
antibodies interval from delivery to the diagnosis of neonatal infection (e.g. exposure to 2020. doi:10.1016/j.ajog.20
maternal respiratory secretions after birth), is crucial in differentiating 20.04.039
congenital from perinatal infection. The low presence of viremia
49
(observed in only 1% of symptomatic adults) decreases the likelihood of
placental infection. In addition, the interpretation of IgM and IgG antibodies
levels in cord and neonatal blood, in the context of serological evidence for
vertical transmission, is also discussed in this review.
Neonatal, late 2-May-20 Neonatal Late American Short This observational study aimed to evaluate post-discharge SARS-CoV-2 This case report Buonsenso D, Costa S,
onset infection, Onset Infection Journal of Communication status of newborns (born to pregnant women with COVID-19) who were describes one case of Sanguinetti M, et al.
pregnancy, With Severe Perinatology negative for SARS-CoV-2 infection at birth. Of seven pregnant women with late-onset, Neonatal Late Onset
breastfeeding, Acute documented SARS-CoV-2 infection, one woman had a spontaneous abortion asymptomatic neonatal Infection with Severe Acute
maternal Respiratory at 8 weeks of gestational age, four women recovered and are still in follow- infection, following Respiratory Syndrome
antibodies, Syndrome up, and two women delivered, at term and pre-term respectively. At birth delivery by a COVID-19 Coronavirus 2 [published
Italy Coronavirus 2 and 3 days of life, both neonates were negative for SARS-CoV-2 infection. At positive mother. It is online, 2020 May 2]. Am
the 15-day follow-up, one newborn tested positive on nasopharyngeal swab, possible that maternal J Perinatol. 2020.
although he was asymptomatic. This newborn had been breastfed by his SARS-CoV-2 IgG doi:10.1055/s-0040-
mother, who wore a mask while recovering from COVID-19. Since antibodies, 1710541
breast milk samples tested negative, respiratory secretions were the likely documented in
source of late-onset neonatal infection. Authors speculate that SARS-CoV-2 neonatal blood at birth,
IgG antibodies (documented at birth in neonatal blood) protected the protected the newborn
newborn from symptomatic infection, preserving the benefits of from a symptomatic
breastfeeding. At follow-up, the second newborn tested negative for SARS- course of infection.
CoV-2 on nasopharyngeal and rectal swabs and had been fed
expressed milk by his father. These findings highlight the importance of long-
term follow-up of newborns to mothers with COVID-19 in pregnancy.
Pregnancy 1-May-20 Potential Taiwanese Correspondence To date, there are limited data on the consequences of COVID-19 on In light of SARS-CoV-2 Tseng JY. Potential
complications, Implications of Journal of pregnancy; however, SARS in 2003 and MERS in 2012 were responsible for having similar implications of SARS-CoV-2
adverse SARS-CoV-2 on Obstetrics and severe complications during pregnancy. In a review of previous coronavirus pathogenic on pregnancy. Taiwan
neonatal Pregnancy Gynecology infections in pregnancy, there were 13 cases of SARS-CoV and 11 cases of characteristics as SARS- J Obstet Gynecol.
outcomes, fetal MERS-CoV reported in the literature. Maternal outcomes of the 13 SARS CoV and MERS-CoV, 2020;59(3):464‐
death, SARS- cases include: 4 had miscarriage, 2 opted for termination of pregnancy, 2 pregnant women who 465. doi:10.1016/j.tjog.2020
CoV, MERS- required mechanical ventilation, 3 were treated conservatively, and 2 died. become infected are at .03.025
CoV No neonatal adverse effect was noted except for 2 premature births. risk for adverse
Maternal outcomes of the 11 MERS-CoV cases include: 2 were maternal and fetal
asymptomatic, 2 required mechanical ventilation, 3 were treated complications.
conservatively, 1 refused treatment, and 3 died. 2 cases of intrauterine fetal
demise and 1 fetal death due to prematurity were reported. Neonatal
infection due to possible vertical transmission was not detected in any of
the SARS or MERS cases, except for 1 SARS case in the United States where
cord blood and breast milk were positive for the SARS-CoV antibody.
Breastfeeding, 1-May-20 Breastfeeding of Annals of Rapid Review This systematic review examined 4,481 records to assess mother-to-child There is no evidence of Yang N, Che S, Zhang J, et al.
Infants, infants born to Translational transmission through milk and respiratory droplets during breastfeeding of detected viral nucleic COVID-19 Evidence and
Mother-to-child mothers with Medicine mothers with COVID-19, SARS, MERS and influenza. Current findings indicate acid in breast milk of Recommendations Working
transmission COVID-19: a that SARS-CoV-2 viral nucleic acid has not been detected in breast milk and mothers with COVID-19. Group (2020). Breastfeeding
rapid review the benefits of breastfeeding may outweigh the risk of SARS-CoV-2 infection Taking appropriate of infants born to mothers
in infants. This article did conclude that because SARS-CoV-2 is transmitted precautions can reduce with COVID-19: a rapid
via close contact and droplets, transmission from mother to infant may be the risk of transmission review. Annals of
possible while breastfeeding. However, by taking effective precautions, the contact during translational medicine,
risk of transmission while breastfeeding can be reduced but not entirely breastfeeding. The 8(10), 618.
avoided. benefits of doi:10.21037/atm-20-3299
50
breastfeeding are thus
likely to outweigh the
risk of COVID-19
infection in infants.
Children, 1-May-20 Children with New England Correspondence The Coronavirus Infection in Pediatric Emergency Departments Most children with Parri N, Lenge M,
pediatric Covid-19 in Journal of (CONFIDENCE) study involved a cohort of 100 Italian children (<18 years) COVID-19 in this Italian Buonsenso D. Children with
emergency Pediatric Medicine with COVID-19, confirmed by RT-PCR testing of nasal or nasopharyngeal cohort had mild Covid-19 in Pediatric
department, Emergency swabs. Children (median age 3.3 years, range 0-27.5 years) were assessed disease; no deaths were Emergency Departments in
clinical Departments in between March 3 and March 27, 2020 in 17 pediatric emergency reported. The incidence Italy [published online, 2020
characteristics, Italy departments. Exposure to SARS-CoV-2 from an unknown source or from a of transmission through May 1]. NEJM.
epidemiology, source outside the child’s family accounted for 55% of the cases of infection. family cluster exposure doi:10.1056/NEJMc2007617
Italy Common symptoms were cough (44%) and no feeding or difficulty feeding was lower in this
(23%). Among the entire cohort, 21% of patients were asymptomatic, 58% cohort, compared to
had mild disease, 19% had moderate disease, 1% had severe disease, and 1% previously studied
were in critical condition. Of the 9 patients who received respiratory cohorts in other
support, 6 had coexisting conditions. No deaths were reported. countries.
Children, 1-May-20 Rapid Advice Annals of Guideline An international multidisciplinary working group developed the present To the authors' Liu E, Smyth RL, Luo Z, et al.
infants, Guidelines for Translational rapid advice guidelines for management of children with COVID-19 using the knowledge, this Rapid advice guidelines for
neonates, Management of Medicine methods and process proposed by the WHO and GRADE working group. This guideline is the first management of children
diagnosis, Children With guideline focuses on the management of children younger than 18 years old international rapid with COVID-19. Ann Transl
screening, COVID-19 infected with SARS-CoV-2, including screening, diagnosis, treatment, and advice guideline for Med. 2020;8(10):617.
management, patient education. The target users of the guideline include pediatricians, management of doi:10.21037/atm-20-3754
patient clinical pharmacists, general practitioners, nurses, policy makers, national children with COVID-19
education, ministries of health, child rights advocacy groups and other health workers based on WHO
breastfeeding, in general and children’s hospitals, primary clinics and communities guidance approach,
WHO worldwide, as well as families involved in the prevention and control of supported by
COVID-19 in children. The article proposes clinical questions, accompanied systematic review of
by rationale and evidence summaries to support the outline existing guidelines.
recommendations. For example, breastfeeding mothers with SARS-CoV-2
infection should continue to breastfeed their newborns, while taking
appropriate precautions, based on limited evidence of viral transmission via
breastmilk.
Pregnancy, 1-May-20 Coronavirus Obstetrics & Current Although guidelines for pregnant women have been rapidly developed This review discusses Rasmussen SA, Jamieson DJ.
mother- Disease 2019 Gynecology Commentary based on the best available evidence, additional information is critically current guidelines for Coronavirus Disease 2019
newborn (COVID-19) and needed to inform key decisions, such as whether pregnant health care infection control in (COVID-19) and Pregnancy:
separation, Pregnancy: workers should receive special consideration, whether to temporarily pregnant women. Responding to a Rapidly
breastfeeding, Responding to a separate infected mothers and their newborns, and whether it is safe for Evolving Situation. Obstet
infection Rapidly Evolving infected women to breastfeed. Some current recommendations are well Gynecol. 2020;135(5):999‐
control, Situation supported, based largely on what we know from seasonal influenza: patients 1002.
prenatal clinics should avoid contact with ill persons, avoid touching their face, cover coughs doi:10.1097/AOG.00000000
and sneezes, wash hands frequently, disinfect contaminated surfaces, and 00003873
stay home when sick. Prenatal clinics should ensure all pregnant women and
their visitors are screened for fever and respiratory symptoms, and
symptomatic women should be isolated from well women and required to
wear a mask. The authors recommend that as COVID-19 rapidly spreads,
obstetricians must keep up to date on the latest information.
51
Breastfeeding, 28-Apr-20 Distance, Maternal & Letter to the Since December 2019, a team of health and social scientists have captured An analysis of Twitter Moukarzel S, del Fresno M,
social media, Diffusion, and Child Nutrition Editor Twitter data and employed social network analyses to examine the diffusion data revealed that the Bode L, Daly AJ. Distance,
Twitter data, the Role of Social of pseudoscience and misinformation related to breastfeeding. Our findings majority of tweets Diffusion, and the Role of
scientific Media in a Time indicate a “breastfeeding and COVID-19” social network totaling 756 unique related to COVID-19 Social Media in a Time of
guidance of COVID users, 880 tweets and 28 distinct communities. The WHO and other and breastfeeding COVID Contagion [published
Contagion professional users act as key diffusers of information. While the vast reflects scientific online 2020 April 28].
majority of tweets reflected current scientific guidance, updates from guidance. Vigilance is doi:10.1111/mcn.13025
researchers about ongoing COVID-19 studies, as well as community still necessary to
engagement and breastfeeding advocacy, 6% of tweets contained counter the diffusion
scientifically unfounded recommendations and commercial promotions. misinformation.
Pregnancy, 28-Apr-20 Clinical Science Short In this retrospective study, five pregnant women were admitted between Five neonates, born to Xu L, Yang Q, Shi H, et al.
neonates, Presentations Bulletin Communication January 21 and February 9, 2020 to Wuhan Union Hospital. All patients were mothers with confirmed Clinical presentations and
cesarean and Outcomes of >34 weeks' gestation and presented with fever or respiratory symptoms. All COVID-19 in Wuhan, outcomes of SARS-CoV-2
section, China SARS-CoV-2 were SARS-CoV-2 positive, confirmed by real-time RT-PCR and developed China, tested negative infected pneumonia in
Infected mild pneumonia during the course of hospitalization. Four patients delivered for SARS-CoV-2 pregnant women and health
Pneumonia in by cesarean section, and one delivered vaginally. Neonates were separated infection in throat swab status of their neonates
Pregnant from their mothers at birth, without breastfeeding. There were no samples. [published online, 2020 Apr
Women and respiratory symptoms observed in neonates, and all tested negative on 28]. Sci Bull (Beijing). 2020.
Health Status of SARS-CoV-2 RT-PCR, using throat swab specimens collected at zero (1/5), doi:10.1016/j.scib.2020.04.0
Their Neonates one (2/5), or eight (2/5) days after birth. 40
Pregnancy, 27-Apr-20 Vaginal Delivery BJOG: An Main Research This retrospective study enrolled 42 pregnant women with COVID-19, who Findings from this study Ferrazzi E, Frigerio L, Savasi
vaginal in SARS-CoV-2 International Article were admitted to 12 participating centers in northern Italy and delivered suggest that vaginal V, et al. Vaginal delivery in
delivery, Infected Journal of between March 1-20, 2020. Twenty-four (57.1%, 95% CI: 41.0-72.3) women delivery is associated SARS-CoV-2 infected
neonatal Pregnant Obstetrics & delivered vaginally. An elective cesarean section was performed in 18/42 with low risk of intra- pregnant women in
infection, Women in Gynecology (42.9%, 95% CI: 27.7-59.0) cases––in 8 cases the indication was unrelated to partum SARS-CoV-2 Northern Italy: a
vertical Northern Italy: A COVID-19 infection. Pneumonia was diagnosed in 19/42 (45.2%, 95% CI: transmission. Two retrospective analysis
transmission, Retrospective 29.8-61.3) cases. Of these, 7/19 (36.8%, 95% CI: 16.3-61.6) required oxygen neonates, born to [published online, 2020 Apr
breastfeeding, Analysis support and 4/19 (21.1%, 95% CI: 6.1-45.6) were admitted to a critical care mothers who were 27]. BJOG. 2020.
Italy unit. In 10 cases, breastfeeding was permitted. Two women breastfed diagnosed with COVID- doi:10.1111/1471-
without a mask because COVID-19 was diagnosed in the post-partum period; 19 postpartum and did 0528.16278
their newborns tested positive for SARS-CoV-2 infection. In another case, a not wear masks while
newborn was vaginally delivered and immediately separated from his breastfeeding, tested
mother, who developed severe postpartum hemorrhage. Within a few positive for SARS-CoV-2.
hours, the newborn developed gastrointestinal symptoms, and after three days Other breastfed infants,
he developed respiratory symptoms and was transferred to the NICU where whose mothers wore a
he recovered after one day of mechanical ventilation. The first newborn test mask, tested negative.
for SARS-CoV-2 was equivocal a few hours after delivery, but positive three
days later. The mother did not breastfeed. No associated health care providers
had a confirmed diagnosis of COVID-19 infection. No other positive SARS-
CoV-2 test was found among the newborns.
Pediatrics, 27-Apr-20 Challenges for The Pediatric Letter to the Apart from the management of febrile children, pediatricians will also have This letter raises Gkentzi D, Karatza A,
neonates, fetal the Pediatricians Infectious Editor to face challenges of SARS-CoV-2 infection during the neonatal period. The important areas of Dimitriou G. Challenges for
development, During the Disease first priority is identifying the timing of infection (antenatally, perinatally or uncertainty, related to the Pediatricians During the
breastfeeding Coronavirus Journal postnatally) and confirming its presence. In the potential case of a neonate fetal and neonatal Coronavirus Disease 2019
Disease 2019 infected in utero, the timing of infection may impact fetal development and SARS-CoV-2 infection. (COVID-19 Coronavirus
(COVID-19 possibly longer-term outcomes. It is unknown whether acquisition of COVID- Disease 2019) Pandemic
Coronavirus 19 during the first trimester of pregnancy is associated with birth defects, or Start From the Neonatal
52
Disease 2019) whether fetal infection is more likely in advanced pregnancy stages, similar Period [published online,
Pandemic Start to other congenital infections. It is also uncertain whether two tests are 2020 Apr 27]. Pediatr Infect
From the enough to rule out neonatal infection, given that serology is not always Dis J. 2020.
Neonatal Period reliable. Guidelines on separation of infected mother and neonate and doi:10.1097/INF.000000000
feeding options are mixed. 0002713
Infant, fever, 27-Apr-20 COVID-19: Fever Anales de Case Report This case report describes a 26-day-old male who was brought to the A COVID-19 positive Chacón-Aguilar R, Osorio-
neurologic Syndrome and Pediatría emergency department (ED) after experiencing 2 paroxysmal episodes. The infant initially Cámara JM, Sanjurjo-
manifestations, Neurological first episode manifested with upward eye rolling and generalized hypertonia presented with fever Jimenez I, González-
hypertonia, Symptoms in a lasting several minutes and associated with a feeding. The second episode and neurologic González C, López-Carnero
Spain Neonate manifested with generalized hypertonia and facial cyanosis lasting several manifestations. The J, Pérez-Moneo-Agapito B.
minutes during sleep. On presentation to the ED, the infant had fever, nasal neurotropic properties COVID-19: Fever syndrome
discharge, and vomiting. The infant was exclusively breastfed and had of SARS-CoV-2 virus and neurological symptoms
adequate weight. Given the presence of fever with neurologic warrant further in a neonate [published
manifestations, empirical antibiotic therapy was initiated until cultures attention and research. online, 2020 Apr 27]. An
yielded negative results. Blood, urine, cerebrospinal fluid and stool cultures Pediatr (Engl Ed). 2020.
were negative, and the stool was negative for RSV and influenza A and B doi:10.1016/j.anpede.2020.
viruses. The PCR test for SARS-CoV-2 detection was positive. The infant was 04.001
discharged after 6 days, without evidence of convulsive seizures. Previous
studies have demonstrated the neurotropic properties of coronaviruses,
including in children <6 years old. However, the pathogenesis of febrile
seizures is not directly related to the neuro-invasiveness of coronaviruses, so
further research is required to understand their role in seizure etiology.
Children, 26-Apr-20 Do Not Neglect Indian Correspondence This brief correspondence provides an overview of various issues concerning This correspondence Naseri A, Hosseini MS. Do
neonates, the Children: Pediatrics children during the COVID-19 pandemic. These include clinical course of from Indian authors Not Neglect the Children:
breastfeeding, Considerations disease, reasons behind lower prevalence of COVID-19 among children promotes indirect Considerations for COVID-
India for COVID-19 compared to adults, asymptomatic transmission, breast feeding, and the breastfeeding for 19 Pandemic [published
Pandemic effects of lockdown on children's mental and physical health. COVID-19 positive online, 2020 Apr 26]. Indian
mothers. Pediatr.
2020;S097475591600165.
Pregnancy, 24-Apr-20 Severe Acute Obstetrics & Research Letter Authors report seven cases of confirmed COVID-19 during late pregnancy 1 out of 7 neonates, Hu X, Gao J, Luo X, et al.
neonate, Respiratory Gynecology and neonatal outcomes, observed from January 20 to February 20, 2020. born to mothers with Severe Acute Respiratory
vertical Syndrome Prior to COVID-19 diagnosis, six of the pregnancies had been uneventful, and confirmed COVID-19 in Syndrome Coronavirus 2
transmission, Coronavirus 2 one had presented with liver dysfunction. No mother experienced clinical late pregnancy, tested (SARS-CoV-2) Vertical
amniotic fluid (SARS-CoV-2) deterioration, and there were no delivery-related complications. Amniotic positive for SARS-CoV-2 Transmission in Neonates
samples, China Vertical fluid samples were obtained at delivery and were negative by PCR testing. infection in throat Born to Mothers With
Transmission in Cesarean delivery was performed for all but one woman, who delivered swabs, suggesting the Coronavirus Disease 2019
Neonates Born vaginally. All neonates were tested within the first 24-36 hours of life, and potential for vertical (COVID-19) Pneumonia
to Mothers With one (14.3%) was positive for SARS-CoV-2 infection in throat swabs. The transmission, although [published online, 2020 Apr
Coronavirus neonates were isolated for 14 days and exclusively formula-fed. infrequent. 24]. Obstet Gynecol. 2020.
Disease 2019 doi:10.1097/AOG.00000000
Pneumonia 00003926
Pregnancy, 24-Apr-20 Protection by Obstetrics & Commentary Governmental institutions and pharmaceutical companies are racing to find Without clear Costantine MM, Landon
exclusion Exclusion: Gynecology therapeutics and vaccines that target COVID-19. However, pregnant and justification for MB, Saade GR. Protection
criteria, clinical Another Missed breastfeeding women are excluded from participating in clinical trials during exclusion, clinical trials by Exclusion: Another
trial, Opportunity to this pandemic. This "protection by exclusion" of pregnant women from drug to develop therapeutics Missed Opportunity to
therapeutics, Include Pregnant development and clinical therapeutic trials, even during pandemics, is not and vaccines against Include Pregnant Women in
Women in unprecedented. Moreover, it is both misguided and not justifiable and may COVID-19 should Research During the
53
vaccine Research During have excluded them from potentially beneficial interventions. This is another include pregnant Coronavirus Disease 2019
development the Coronavirus missed opportunity to obtain pregnancy-specific safety and efficacy data, women. (COVID-19) Pandemic
Disease 2019 because therapeutics developed for men and nonpregnant women may not [published online, 2020 Apr
(COVID-19) be generalizable to pregnant women. Therefore, authors recommend and 24]. Obstet Gynecol. 2020.
Pandemic urge the scientific community and professional societies that, without clear doi:10.1097/AOG.00000000
justification for exclusion, pregnant women should be given the opportunity 00003924
to be included in clinical trials for COVID-19 based on the concepts of justice,
equity, autonomy, and informed consent.
Pregnancy, 23-Apr-20 Coronavirus American Case Series Clinical records were retrospectively reviewed for 116 pregnant women with Based on this report of Yan J, Guo J, Fan C, et al.
neonates, Disease 2019 Journal of COVID-19 pneumonia from 25 hospitals in China between January 20 and 116 cases of pregnant Coronavirus disease 2019
clinical (COVID-19) in Obstetrics and March 24, 2020. The median gestational age on admission was 38+0 (IQR: women with COVID-19 (COVID-19) in pregnant
characteristics, Pregnant Gynecology 36+0 -- 39+1) weeks. The most common symptoms were fever (50.9%, in China, SARS-CoV-2 women: A report based on
preterm birth, Women: A 59/116) and cough (28.4%, 33/116); 23.3% (27/116) patients presented infection during 116 cases [published online,
vertical Report Based on without symptoms. Abnormal radiologic findings were found in 96.3% pregnancy was not 2020 Apr 23]. Am J Obstet
transmission, 116 Cases (104/108) of cases. There were eight cases (6.9%, 8/116) of severe associated with Gynecol. 2020.
amniotic fluid, pneumonia but no maternal deaths. One of eight patients (1/8) that increased risk of doi:10.1016/j.ajog.2020.04.
cord blood presented in the first- and early-second trimester had a missed spontaneous spontaneous abortion 014
samples, China abortion. 85.9% (85/99) underwent Cesarean delivery and 14.1% (14/99) and preterm birth.
had a vaginal delivery. For 38.8% (33/85) of those who underwent Cesarean There was no evidence
delivery, the indication was COVID-19 pneumonia. Twenty-one of 99 of vertical transmission
patients (21.2%, 21/99) that had delivered had preterm birth, including six of SARS-CoV-2 infection
with preterm premature ruptured of membranes. The rate of spontaneous during late pregnancy.
preterm birth before 37 weeks was 6.1% (6/99). There was one case of
severe neonatal asphyxia that resulted in neonatal death. Eighty-six of the
100 neonates were tested for SARS-CoV-2; all had negative results. Of these,
ten neonates had paired amniotic fluid and cord blood samples that were
tested negative for SARS-CoV-2. Six mothers had their vaginal secretion
samples tested and were negative. Twelve mothers had their breast milk
samples tested and were negative.
Pregnancy, 23-Apr-20 Management of International Brief Data are emerging on the consequences of the infection on mothers and An OB/GYN department Sharma KA, Kumari R,
neonate, the First Patient Journal of Communication infants. Many guidelines on pregnancy management during the pandemic in India describes the Kachhawa G, et al.
obstetric unit, With Confirmed Gynecology & have been released, but the actual journey to establishing an obstetric process of establishing Management of the first
breastfeeding, COVID-19 in Obstetrics isolation unit can be challenging. The present article describes the stepwise an obstetric isolation patient with confirmed
India Pregnancy in informed approach that was taken to rapidly establish a unit for suspected unit, where an COVID-19 in pregnancy in
India: From COVID‐19 patients within existing resources, and the experience of asymptomatic pregnant India: From guidelines to
Guidelines to delivering the first pregnant patient with asymptomatic, confirmed COVID‐ woman with COVID-19 frontlines [published online,
Frontlines 19 in India. A healthy male neonate was delivered by cesarean section, was delivered a healthy 2020 Apr 23]. Int J Gynaecol
breastfed, and tested negative for COVID-19 on day seven. neonate, who was Obstet. 2020.
breastfed and tested doi:10.1002/ijgo.13179
negative for COVID-19.
Human milk 23-Apr-20 Use of Journal of Original Article This paper reports experience from the Human Milk Bank (HMB) of a A human milk bank Rose DU, Reposi MP,
bank, Disinfectant Human children's hospital in Rome, Italy. Donors express milk via mechanical pumps from Rome, Italy Amadio P, et al. Use of
breastfeeding, Wipes to Lactation and store milk in sterile single-use plastic containers supplied by the HMB. reports experiences Disinfectant Wipes to
sanitization, Sanitize Milk's While milk donation was practically suspended in other Italian cities, drivers adapting to the COVID- Sanitize Milk's Containers of
Rome, Italy Containers of at this HMB continue to collect expressed human milk (EHM) directly from 19 era, through less Human Milk Bank During
Human Milk Ban donors, once a week. Milk is frozen, then defrosted and pasteurized before frequent COVID-19 Pandemic
use. Breastfeeding information is provided to the mothers via telephone donated milk collection [published online, 2020 Apr
54
k During COVID- consultation available 8 hours a day. It is recommended that donor mothers and sanitization of 23]. J Hum Lact. 2020.
19 Pandemic suspend donation and be promptly tested if any SARS-CoV-2 symptoms containers. doi:10.1177/089033442092
occur; however, SARS-CoV-2 could contaminate the outside of the container, 4639
since this virus can be detected for up to 72 hours on plastic and various
surfaces. Therefore, the HMB has begun to sanitize EHM containers using
disinfectant wipes and gloved hands, which is both feasible and sustainable.
Infant, fever, 22-Apr-20 Fever Without a Journal of the Brief Report A 5-week-old infant was admitted for fever, without a source (but who had This unexpected Kan MJ, Grant LMC, Muña
clinical Source in a Pediatric known sick contacts, including her father), at Kaiser Permanente Northern presentation of an MA, Greenhow TL. Fever
characteristics, Young Infant Due Infectious California San Francisco Emergency Department. The infant subsequently infant with fever without a source in a young
San Francisco to SARS-CoV-2 Diseases tested positive for SARS-CoV-2 based on a combination of oropharyngeal without a source infant due to SARS-CoV-2
Society and bilateral nasopharyngeal swab sent for qualitative nucleic amplification. changed regional [published online, 2020 Apr
The infant was born full-term and had a history of hydronephrosis and hospital screening 22]. J Pediatric Infect Dis
duplex kidney. She had a mild hospital course, without respiratory distress, procedures for COVID- Soc. 2020.
and fever resolved within 30 hours of hospitalization. She continued to 19. doi:10.1093/jpids/piaa044
breastfeed while the mother wore a mask.
Neonatal 22-Apr-20 Late-Onset New England Correspondence A 3-week-old boy presented with a 2-day history of nasal congestion, This case illustrates a Coronado Munoz A,
infection, Neonatal Sepsis Journal of tachypnea, and reduced feeding. He was born at 36 weeks of gestation to a severe case of neonatal Nawaratne U, McMann D,
sepsis, in a Patient With Medicine 21-year-old woman (gravida 3, para 1). On transfer from the emergency COVID-19 in a 3-week- Ellsworth M, Meliones J,
mechanical Covid-19 department to a pediatric hospital, the patient had hypotension, old boy, who was Boukas K. Late-Onset
ventilation, tachycardia, hypothermia, and tachypnea. Chest radiography performed managed with standard Neonatal Sepsis in a Patient
pneumothorax, after intubation showed bilateral infiltrates and partial collapse of the right PICU protocols. with Covid-19 [published
hydroxy- upper lobe. Transthoracic echocardiography showed normal cardiac online, 2020 Apr 22]. N Engl
chloroquine, anatomy and function. The white-cell count was 4000 per cubic millimeter J Med. 2020.
azithromycin with 55% lymphocytes; levels of inflammatory markers were elevated. doi:10.1056/NEJMc2010614
Mechanical ventilation was initiated, and hydroxychloroquine and
azithromycin were initiated for presumed COVID-19. On day 2 after
admission, the hypotension resolved. A pneumothorax that developed on
the right side and was successfully treated by tube thoracostomy. The
results of RT-PCR testing to detect SARS-CoV-2 on admission, from nasal
swabs, were positive on day 7; he completed the 5-day course of
hydroxychloroquine and azithromycin. The patient was discharged on day 9
without supplemental oxygen.
Sexual and 21-Apr-20 Not a luxury: a The Lancet Comment About 1.8 billion people live in fragile contexts worldwide, including 168 Experience from past Nguyen TT, Tappis H,
reproductive call to maintain Global Health million individuals in need of humanitarian assistance. Approximately a epidemics in these Spilotros N, Krause S,
health, fragile sexual and quarter of those in fragile contexts are women and girls of reproductive age, settings has showed Knaster S, for the Inter-
settings, reproductive with countries affected by fragility and crisis accounting for 61% of maternal that discontinuing Agency Working Group on
humanitarian health in deaths worldwide. Experience from past epidemics in these settings has health-care services Reproductive Health in
settings, humanitarian showed that discontinuing health-care services deemed unrelated to the deemed unrelated to Crises. Not a luxury: a call to
obstetric and and fragile epidemic response resulted in more deaths than did the epidemic itself. the epidemic response maintain sexual and
newborn care, settings during Poor health outcomes will surge from the absence or disruption of lifesaving resulted in more deaths reproductive health in
breastfeeding the COVID-19 services, including emergency obstetric and newborn care. Early and than did the epidemic humanitarian and fragile
pandemic exclusive breastfeeding and skin-to-skin contact for neonates should be itself. settings during the COVID-
promoted, and mother and neonate should not be separated unless one or 19 pandemic. Lancet. 2020,
both are critically ill in cases of suspected or confirmed COVID-19 infections doi:10.1016/S2214-
109X(20)30190-X
55
Pregnancy, 20-Apr-20 Cesarean Section Acta Médica Case Report Authors report the first cesarean delivery in a woman with COVID-19 at a No adverse maternal or Lyra J, Valente R, Rosário M,
neonate, in a Pregnant Portuguesa level III hospital in Portugal. A healthy 35-year-old woman with a term neonatal outcomes Guimarães M. Cesarean
cesarean Woman With pregnancy tested positive for SARS-CoV-2 infection, on RT-PCR of were observed in this Section in a Pregnant
delivery, COVID-19: First nasopharyngeal and oropharyngeal swabs, on the day of labor induction. case report of cesarean Woman with COVID-19:
Portugal Case in Portugal Given a Bishop score < 4 and prior history of a cesarean section, the team delivery of a newborn First Case in Portugal
decided to perform a surgical delivery. The newborn was separated from his by a mother with [published online, 2020 Apr
mother immediately after birth. Newborn nasal and oropharyngeal swabs confirmed COVID-19. 20]. Acta Med Port. 2020.
were all negative for SARS-CoV-2. The mother began mechanical breast doi:10.20344/amp.13883
stimulation to begin breastfeeding after recovering from COVID-19.
Maternal-infant 20-Apr-20 Managing Breast-feeding Correspondence This report describes two cases of maternal-infant dyads, in which all This Salvatori G, De Rose
dyad, COVID-19- Medicine four individuals tested positive by nasopharyngeal swab for SARS-CoV-2, at a report of two confirmed DU, Concato C, et al.
breastfeeding, Positive referral care center in Rome, Italy. Mother 1 and newborn 1 were 36 years COVID-19 maternal- Managing COVID-19-
breast milk sam Maternal-Infant old and 18 days old at admission, respectively. Mother 2 and newborn 2 infant dyads in Rome, Positive Maternal-Infant
ples, Italy Dyads: An Italian were 26 years old and 10 days old at admission, respectively. Neither the Italy did not find Dyads: An Italian Experience
Experience mothers nor the infants required intensive care unit admission. Viral nucleic evidence of viral nucleic [published online, 2020 Apr
acid was not detected by RT-PCR in expressed breast milk samples of both acid in 20]. Breastfeed Med. 2020,
mothers. To the authors' knowledge, these are the first data on postnatal breast milk samples. doi:10.1089/bfm.2020.0095
horizontal COVID-19 infection in newborns and breast milk analysis in Italy.
Children, 18-Apr-20 Novel Turkish Review Article According to the current literature, children account for 1-5% of diagnosed Authors Bedir Demirdağ T, Tezer H.
clinical Coronavirus Journal of COVID-19 cases. Approximately 90% of pediatric patients are diagnosed with comprehensively review Novel Coronavirus disease
characteristics, Disease (COVID- Medical asymptomatic, mild, or moderate disease. However, up to 6.7% of cases may existing literature on (COVID-19) in children
epidemiology, 19) in Children Sciences be severe. Severe illness is generally seen in patients younger than 1 year of the pathogenesis, [published online, 2020 Apr
vertical age and patients who have underlying diseases. The epidemiological and transmission, 18]. Turk J Med Sci. 2020.
transmission clinical patterns of COVID-19 and treatment approaches in pediatric patients epidemiology, clinical doi:10.3906/sag-2004-174
still remain unclear. Mother to infant transmission of SARS-CoV-2, through findings, diagnosis, and
breast milk or vertical transmission, is also controversial. This review treatment of COVID-19
summarizes the current epidemic, clinical presentation, diagnosis, and in pediatric patients.
treatment of COVID-19 in pediatric patients.
Neonate, 17-Apr-20 Preterm delivery Prenatal Research Letter On March 7, 2020, a 22-year-old female (32 weeks' gestation), presented at In this case report from Zamaniyan M, Ebadi A, Agha
preterm in pregnant Diagnosis Imam Khomeini Hospital in Sari, Iran with a 4-day history of dyspnea, Iran, amniotic fluid and janpoor Mir
delivery, woman with myalgia, anorexia, nausea, non-productive cough and fever. The neonatal nasal/throat S, Rahmani Z, Haghshenas
amniotic fluid critical COVID-19 mother’s nasopharyngeal swabs tested positive for SARS-CoV-2. On March swab samples tested M, Azizi S. Preterm delivery
sample, pneumonia and 11, a preterm female neonate was delivered via cesarean section, weighing positive for SARS-CoV-2 in pregnant woman with
maternal death vertical 2.35kg; she was kept in an isolated NICU and fed with powdered milk. following cesarean critical COVID-19
transmission Umbilical cord blood and neonatal nasal and throat swab samples, collected delivery by a mother pneumonia and vertical
after delivery, tested negative for SARS-CoV-2 on RT-PCR; whereas, amniotic with COVID-19. The transmission [published
fluid samples tested positive. 24 hours later, the neonate's nasal and throat mother died due to online, 2020 Apr
swab samples turned positive for SARS-CoV-2. After cesarean delivery, the respiratory 17]. Prenat Diagn. 2020.
mother's condition progressively worsened, despite treatment with complications. doi:10.1002/pd.5713
antivirals and corticosteroids, and she died on March 26.
Pregnancy, 17-Apr-20 Clinical New England Correspondence From December 8, 2019, to March 20, 2020, 118 pregnant women with In this study of 118 Chen L, Li Q, Zheng D, et al.
neonates, Characteristics of Journal of COVID-19 in Wuhan were identified in the epidemic reporting system of the pregnant women with Clinical Characteristics of
clinical Pregnant Medicine National Health Commission of China. 84 women (71%) had positive PCR COVID-19, there were Pregnant Women with
characteristics, Women With Co testing for SARS-CoV-2 infection, and the remaining 34 (29%) had suggestive no maternal deaths. Of Covid-19 in Wuhan, China
abortions, vid-19 in Wuhan, findings on chest CT. 75 of 118 (64%) had been infected with SARS-CoV-2 in 68 women who [published online, 2020 Apr
breast milk sam China the third trimester. The most common symptoms in 112 women with delivered during the 17]. N Engl J Med. 2020.
ples, China available data were fever (in 75%) and cough (in 73%). Lymphopenia was study period, 63 (93%)
56
present in 51 of 116 patients (44%). A total of 88 of the 111 women (79%) underwent cesarean doi:10.1056/NEJMc2009226
who underwent chest CT had infiltrates in both lungs. A total of 109 of 118 section. All neonates
women (92%) had mild disease, and 9 (8%) had severe disease (hypoxemia), tested negative for
1 of whom received noninvasive mechanical ventilation (critical disease). COVID-19 infection.
Severe disease developed in 6 of the 9 women after delivery. There were no Breastmilk samples also
deaths. Among the study population, there were 3 spontaneous abortions, 2 tested negative.
ectopic pregnancies, and 4 induced abortions (all owing to patients’
concerns about COVID-19). A total of 68 of 118 patients (58%) delivered
during the study period and had 70 births (2 sets of twins). Of these 68
patients, 63 (93%) underwent a cesarean section; in 38 of 62 cases (61%),
the procedure was performed because of concern about the effects of
COVID-19 on the pregnancy. A total of 14 deliveries (21%) were premature;
8 were induced (7 owing to concern about COVID-19). No babies had
neonatal asphyxia. SARS-CoV-2 testing of throat swabs from 8 newborns and
breastmilk samples from 3 mothers was negative.
Neonatal 16-Apr-20 Sequential Clinical Brief Report This brief report describes changes in viral load over time in a 27-day old Nasopharyngeal and Han S, Seong MW, Heo EY,
infection, viral analysis of viral Infectious neonate with COVID-19 who presented with fever, cough, and vomiting. The stool samples from a et al. Sequential analysis of
RNA, South load in a neonate Diseases virus seemed to be transmitted from one of her family members, and the neonate remained viral load in a neonate and
Korea and her mother neonate had been directly breastfed from birth. The neonate was positive for SARS-CoV- her mother infected with
infected with hospitalized on March 8, 2020 and placed in an isolation room with her 2 until 17 and 18 days SARS-CoV-2 [published
SARS-CoV-2. mother. SARS-CoV-2 RNA was detected in the neonate’s nasopharynx, after symptom onset, online, 2020 Apr 16]. Clin
oropharynx, stool, saliva, plasma, and urine. Levels of viral RNA were highest respectively. Viral RNA Infect Dis. 2020.
in the nasopharynx, decreased over time, and were undetectable after 17 was not detected in doi:10.1093/cid/ciaa447
days from onset of symptoms. SARS-CoV-2 RNA in stool samples remained breast milk samples.
high until the 18th day since onset, even though the neonate's
gastrointestinal symptoms had improved. The virus was not detected in the
mother's breast milk.
Neonates, 15-Apr-20 SARS-CoV-2 Clinical Case report This case report focuses on a 2-week-old male infant who presented to the This report highlights Patek P, Corcoran J, Adams
clinical Infection in a 2- Pediatrics pediatric emergency department of Beaumont Hospital, Royal Oak MI, USA, the importance of L, Khandhar P. SARS-CoV-2
symptoms, the Week-Old Male with fever and fussiness. During the 3 days before admission, the mother clinical suspicion of Infection in a 2-Week-Old
USA With noted a progressively worsening erythema of the right thumb and fourth COVID-19 in neonates Male With Neutropenia.
Neutropenia digit. Additionally, the patient had been having increased somnolence over with fever. Neonatal Clin Pediatr (Phila).
the past day and decreased breast milk feeds. There was no nasal patients should be 2020;59(9-10):918-920.
congestion, cough, increased work of breathing, vomiting, nor diarrhea. admitted to a doi:10.1177/000992282092
Hematological studies in the infant demonstrated isolated neutropenia with quarantine ward to 0014
granulocytosis and monocytosis, normal white blood cell, and lymphocyte limit further
count, which is atypical when compared with prior novel coronavirus strains. transmission.
The infant was admitted to the pediatric ICU. On day 1 of admission, the
SARS-CoV-2 PCR returned positive. Apart from fever, the patient exhibited
no other symptoms of COVID-19. On hospital day 4, the patient discharged
home with oral antibiotic therapy for soft tissue infection.
57
Pregnancy, 15-Apr-20 Importance of Clinical Viewpoint Investigators are employing unprecedented innovation in the design of This Viewpoint calls LaCourse SM, John-Stewart
breastfeeding, inclusion of Infectious clinical trials to rapidly and rigorously assess potentially promising therapies attention to the urgent G, Adams Waldorf KM.
therapeutic pregnant and Diseases for COVID-19; this is in stark contrast to the continued, near universal, need to engage Importance of inclusion of
trials breastfeeding regressive practice of excluding pregnant and breastfeeding women from pregnant women in pregnant and breastfeeding
women in these trials. The few trials which allow their inclusion focus on post-exposure COVID-19 treatment women in COVID-19
COVID-19 prophylaxis or outpatient treatment of milder disease, limiting the options trials in order to therapeutic trials [published
therapeutic available to pregnant women with severe COVID-19 to compassionate use of develop data-driven online, 2020 Apr 15]. Clin
trials. remdesivir, or off-label drug use of hydroxychloroquine or other therapies. recommendations Infect Dis. 2020.
These restrictions were put in place despite experience with these drugs in regarding the risks and doi:10.1093/cid/ciaa444
pregnant women. benefits of therapies in
this unique population.
Pregnancy, 15-Apr-20 COVID-19 Australian and Short This case report describes an uncomplicated vaginal birth in a SARS-CoV-2 The SARS-CoV-2 Lowe B, Bopp B. COVID-19
vaginal Vaginal Delivery - New Zealand Communication positive mother at a tertiary Australian hospital. To the authors' knowledge, positive mother vaginal delivery - a case
delivery, A Case Report Journal of this is also the first case describing a mother with COVID‐19 who was not described in this case report [published online,
neonate, Obstetrics and separated from her infant. Management provided supports the current study was not 2020 Apr 15]. Aust N Z J
maternal- Gynaecology Royal College of Obstetricians and Gynaecologists and World Health separated from her Obstet Gynaecol. 2020.
neonatal Organization guidelines suggesting that it is possible to consider rooming in infant following birth. doi:10.1111/ajo.13173
separation, post-delivery for COVID‐19 positive parents. Encouragement of breast Breastfeeding was also
breastfeeding, feeding appears possible and safe when viral precautions are observed. encouraged with
Australia observation of hygiene
precautions.
Pregnancy, 14-Apr-20 SARS-CoV-2: Is it Journal of Review Data are limited on outcomes of COVID-19 disease during pregnancy and Authors consider Muldoon KM, Fowler
neonates, the Newest Clinical consequences for fetuses and newborns. Therefore, information on illnesses limited data on COVID- KB, Pesch MH, Schleiss MR.
TORCH Spark in the Virology associated with other highly pathogenic coronaviruses (i.e. SARS, MERS), as 19 in pregnancy in the SARS-CoV-2: Is it the newest
infection, SARS, TORCH? well as comparisons to common congenital infections, such as context of SARS, MERS, spark in the TORCH?
MERS, vertical cytomegalovirus (CMV), are warranted. Research regarding the potential and common [published online, 2020 Apr
transmission routes of acquisition of SARS-CoV-2 infection in the prenatal and perinatal congenitally or 14]. J Clin Virol.
setting is of a high public health priority. Breast milk acquisition of infection perinatally acquired 2020. doi:10.1016/j.jcv.202
has not been recognized to date, and strategies to ensure that this remains TORCH infections, like 0.104372
the preferred source of infant nutrition are needed. Vaccines targeting CMV.
women of reproductive age, and in particular pregnant patients, should be
evaluated in clinical trials and should include the endpoints of neonatal
infection and disease.
Children, 14-Apr-20 The Intriguing Jornal de Pedi Editorial One of the most striking and consistent findings from COVID-19 reports This editorial provides Safadi MAP. The intriguing
comorbidities, Features of atria globally is that, in contrast with infected adults, children rarely experience an overview of current features of COVID-19 in
vertical COVID-19 in severe forms of the disease. Available data on COVID-19 severity in children literature on notable children and its impact on
transmission, Children and Its with comorbidities are scarce, limiting the possibility to identify conditions at findings related to the pandemic [published
community Impact on the increased risk of complications and mortality. Although at this time we do COVID-19 in children, online, 2020 Apr 14].
transmission, Pandemic not know whether mothers with COVID-19 can transmit the SARS-CoV-2 via highlighting current J Pediatr (Rio J).
treatment, breast milk, the WHO, as well as the Brazilian Society of Pediatrics, made gaps in data. 2020. doi:10.1016/j.jped.20
breastfeeding clear recommendations supporting mothers to breastfeed their infants. A 20.04.001
crucial point for investigation – yet to be determined – is the role of children
in transmission. Despite being asymptomatic or oligosymptomatic, infected
infants and children may have high viral loads in their nasopharynx, as well
as fecal shedding of SARS-CoV-2 for longer periods, thus may play a
substantial role in viral community transmission. At the time of writing,
treatment in children includes fluid and nutritional intake, together with
58
oxygen supplementation and ventilatory support. Due to the rare number of
severe cases in children, there is no data on the safety and efficacy of the
different therapeutic interventions that are being tested in adults.
Neonates, 13-Apr-20 Clinical Frontiers in Research Article Nineteen neonates were admitted to Tongji Hospital from January 31 to No evidence of vertical Liu W, Wang J, Li W, Zhou Z,
clinical Characteristics of Medicine February 29, 2020. Among them, 9 mothers were clinically diagnosed with transmission was found Liu S, Rong Z. Clinical
characteristics, 19 Neonates COVID-19, and 10 mothers had confirmed infection based on RT-PCR testing in this cohort of 19 characteristics of 19
vertical Born to Mothers of throat swab samples. All deliveries occurred in an isolation room, and neonates born to neonates born to mothers
transmission, With COVID-19 neonates were immediately separated from their mothers, for at least 14 mothers with clinically with COVID-19 [published
breast milk sam days. No fetal distress was found. Mean gestational age of the neonates was diagnosed or online, 2020 Apr 13]. Front
ples, China 38.6 ± 1.5 weeks, and mean birth weight was 3293 ± 425 g. SARS-CoV-2 RT- laboratory-confirmed Med. 2020.
PCR test results for throat swab, urine, and feces samples of all neonates COVID-19. Amniotic doi:10.1007/s11684-020-
were negative following birth. RT-PCR test results for breast milk and fluid, cord blood, and 0772-y
amniotic fluid samples were also negative. None of the neonates developed breast milk samples all
clinical, radiologic, hematologic, or biochemical evidence of COVID-19. No tested negative for
vertical transmission of SARS-CoV-2 and no perinatal complications in the SARS-CoV-2.
third trimester were found.
Pregnancy, 11-Apr-20 Unlikely SARS- Journal of Case Report Though some studies indicated the risk of vertical transmission of SARS-CoV- Authors state that Peng Z, Wang J, Mo Y, et al.
neonate, CoV-2 Vertical Infection and 2 infection is low, few cases have been reported with comprehensive serial vertical transmission of Unlikely SARS-CoV-2 vertical
vertical Transmission Fro Public Health tests from multiple specimens. In this case, a female preterm infant was COVID-19 is unlikely transmission from mother
transmission, m Mother to born to a mother with confirmed COVID-19. The infant presented with mild but advise caution, until to child: A case report
breast milk sam Child: A Case respiratory distress and received general management and a short period of further evidence from [published online, 2020 Apr
ples Report nasal continuous positive airway pressure support. During her stay at the epidemiological 11]. J Infect Public Health.
hospital, a series of SARS-CoV-2 nucleic acid tests from her serum, throat surveillance and 2020. doi:10.1016/j.jiph.202
and anal swabs, bronchoalveolar lavage fluid, and urine were experiment studies 0.04.004
negative. Nucleic acid tests of the mother's amniotic fluid, vaginal on transmission
secretions, cord blood, placenta, serum, anal swab, and breast milk were potential through birth
also negative. The most comprehensively tested case reported to date canal contact and
confirmed that the vertical transmission of COVID is unlikely, but still, more breast milk is available.
evidence is needed.
Neonatal 11-Apr-20 Neonatal COVID- Jornal de Editorial The lack of high-quality evidence on neonatal SARS-CoV-2 infection and the Brazilian authors Procianoy RS, Silveira RC,
infection, 19: Little Pediatria steadfast pace of new and conflicting information has been an overall compile existing Manzoni P, Sant'Anna G.
vertical Evidence and the challenge to neonatal intensive care. Internationally and nationally in Brazil, information on how to Neonatal COVID-19: little
transmission, Need for More a number of important groups have been diligently working on the care for neonates with evidence and the need for
breastfeeding, Information development of protocols and guidelines for the neonatal COVID-19 SARS-CoV-2 infection, more information
neonatal outbreak. Given the constant updating and some conflicting information, from a variety of [published online, 2020 Apr
providers, health care providers face difficulties in determining best local guidelines. national and 11]. J Pediatr (Rio J). 2020.
respiratory This editorial outlines what is currently known about neonatal infection, international sources. doi:10.1016/j.jped.2020.04.
strategies, vertical transmission, what neonatal health care providers should do about 002
Brazil COVID-19, how to provide overall care after birth (including notes on
supporting breastfeeding), and respiratory strategies.
Neonate, 10-Apr-20 Vaginal Delivery Journal of Short This case report describes a pregnant woman, who was admitted to A neonate, born to a Xiong X, Wei H, Zhang Z, et
pregnancy, Report of a Medical Communication Beijing YouAn Hospital on January 29, 2020 (33 weeks 1 day gestation) and convalescing mother, al. Vaginal Delivery Report
vaginal Healthy Neonate Virology diagnosed with COVID-19. She received antiviral, anti-infection, and tested negative for of a Healthy Neonate Born
delivery, Born to a corticosteroid therapies and recovered following treatment. Follow-up RT- COVID-19 infection. to a Convalescent Mother
serological Convalescent PCR tests were negative, and virus-specific IgG and IgM antibodies in Although virus-specific with COVID-19 [published
testing, Mother With maternal venous blood were positive. Thirty-seven days after diagnosis, a IgG and IgM were online, 2020 Apr 10]. J
breast milk sam COVID-19 male neonate was delivered successfully by vaginal delivery. RT-PCR testing detected in
59
ples, vertical of breast milk, amniotic fluid, and neonatal throat and rectal samples tested maternal sera Med Virol. 2020.
transmission, negative. Neonatal sera samples were also negative for IgG and IgM following recovery, doi:10.1002/jmv.25857
China antibodies, and SARS-CoV-2 N protein was not detected in the placenta by antibodies were absent
immunohistochemical analysis. Findings indicate that there is no intrauterine in neonatal sera.
transmission in a woman who develops COVID-19 pneumonia in late Breast milk samples
pregnancy. also tested negative.
Perinatology, 10-Apr-20 Perinatal Aspects Journal of Review This review presents analysis of literature on COVID-19 using Medline and This comprehensive Mimouni F,
pregnancy, on the Covid-19 Perinatology Google scholar to summarize available evidence on perinatal aspects of review of available Lakshminrusimha S,
neonates Pandemic: A COVID-19. From scant data: vertical transmission from maternal infection literature on COVID-19 Pearlman SA, et al. Perinatal
Practical during the third trimester probably does not occur or likely it occurs very in pregnant women and aspects on the covid-19
Resource for rarely. Consequences of COVID-19 infection among women during early neonates includes pandemic: a practical
Perinatal- pregnancy remain unknown. Whether or not pregnancy is a risk factor for useful links to resource for perinatal-
Neonatal more severe disease in women with COVID-19 cannot be concluded. Little is guidelines and expert neonatal specialists
Specialists known about disease severity in neonates, and from very few samples, the opinions, as well as [published online, 2020 Apr
presence of SARS-CoV-2 has not been documented in human milk. infographics on 10]. J Perinatol. 2020.
treatment strategies. doi:10.1038/s41372-020-
0665-6
Pregnancy, 9-Apr-20 A Spanish- The Lancet Correspondence No standardized guidelines for treating pregnant women with SARS-CoV-2 Authors translate a Martinez-Portilla, RJ, Goncé,
clinical translated Infectious infection are currently available in Spanish. Authors of this correspondence proposed clinical A, Hawkins-Villarreal, A,
algorithm, clinical algorithm Diseases call for dissemination of the clinical algorithm, proposed by Favre et al. for algorithm for the Figueras F. A Spanish-
Spanish for management the management of pregnant women with suspected COVID-19, to Spanish- management of translated clinical algorithm
of suspected speaking countries where such information is urgently needed. A translated pregnant women with for management of
SARS-CoV-2 algorithm in Spanish is proposed in the appendix, and recommendations for COVID-19 into Spanish. suspected SARS-CoV-2
infection in breastfeeding are discussed as well. infection in pregnant
pregnant women women [published online,
2020 Apr 9]. Lancet Infect
Dis. 2020.
doi:10.1016/S1473-
3099(20)30285-1
Pregnancy, 9-Apr-20 COVID-19 American Case Series Authors describe a series of 43 test-confirmed cases of COVID-19 in No neonates born to Breslin N, Baptiste C,
neonates, infection among Journal of pregnant women presenting to a pair of affiliated New York City hospitals mothers with confirmed Gyamfi-Bannerman C, Miller
universal asymptomatic Obstetrics & over two weeks from March 13 to 27, 2020. Fourteen (32.6%) patients COVID-19 were found R, Martinez R, BernsteinK,
testing, and symptomatic Gynecology presented without any COVID-associated symptoms and were identified to have infection when Ring L, Landau R, Purisch S,
breastfeeding, pregnant MFM either after developing symptoms during admission or following the tested on the first day Friedman AM, Fuchs K,
New York City women: Two implementation of universal testing for all obstetrical admissions on March of life. IgG and IgM Sutton D, Andrikopoulou M,
weeks of 22. Of these, 10/14 (71.4%) developed symptoms or signs of COVID-19 SARS-CoV-2 testing was Rupley D,Sheen J-J, Aubey J,
confirmed infection over the course of their delivery admission or early after not performed. Among Zork N, Moroz L, Mourad M,
presentations to postpartum discharge. Of the other 29 (67.4%) patients who presented with the pregnant women, Wapner R, Simpson LL,
an affiliated pair symptomatic COVID-19 infection, three women ultimately required the proportions of mild, D’Alton ME, GoffmanD,
of New York City antenatal admission for viral symptoms, and an additional patient severe, and critical COVID-19 infection among
hospitals represented six days postpartum with worsening respiratory status that disease are similar to asymptomatic and
required oxygen supplementation. There were no confirmed cases of COVID- those described for symptomatic pregnant
19 detected in neonates upon initial testing on the first day of life. One non-pregnant adults women: Two weeks of
neonate had an "indeterminant" test result, which was clinically managed as with COVID-19. confirmed presentations to
a "presumptive negative" diagnosis. Another neonate was admitted to the Mothers were an affiliated pair of New
NICU for respiratory distress with concern for sepsis at 37 weeks but tested encouraged to York City hospitals,
negative for COVID-19 infection. Healthy newborns either roomed in with breastfeed with proper American Journal of
60
their mothers in isolettes whenever possible or were cared for in an isolated precautions. Universal Obstetrics &Gynecology
nursery. Breastfeeding was encouraged with use of hand hygiene and testing of pregnant MFM (2020),
maternal masking. Applying COVID-19 disease severity characteristics as women upon admission doi:10.1016/j.ajogmf.2020.1
described by Wu et al, 38 (86%) women possessed mild disease, four (9.3%) for delivery has 00118
exhibited severe disease, and two (4.7%) developed critical disease; these potential clinical value,
percentages are similar to those described for non-pregnant adults with to quickly identify
COVID-19 infections (about 80% mild, 15% severe, and 5% critical disease). asymptomatic patients.
Pregnancy, 9-Apr-20 Delivery in International Review Article This study aims to review the available information on mode of delivery, This review of current Parazzini F, Bortolus R,
neonates, Pregnant Journal of vertical/peripartum transmission, and neonatal outcome in pregnant women literature on pregnant Mauri PA, Favilli A, Gerli S,
vertical Women Infected Gynaecology infected with SARS‐CoV‐2. Searches were conducted used a combination of women and neonates Ferrazzi E. Delivery in
transmission, With SARS-CoV- & Obstetrics the following key words: COVID‐19, SARS‐CoV‐2, and pregnancy in Embase with COVID-19 suggests pregnant women infected
breastfeeding, 2: A Fast Review and PubMed databases, from January 1 to March 31, 2020. Of 13 included that the rate of vertical with SARS-CoV-2: A fast
preterm birth studies reporting on 61 pregnant women, vaginal delivery was reported in 6 transmission of SARS- review [published online,
cases (9.4%; 95% CI, 3.5–19.3). Worsening of maternal conditions was the CoV-2 is low, if any, for 2020 Apr 9]. Int J Gynaecol
indication for cesarean delivery in 31 cases (48.4%; 95% CI, 35.8–61.3). cesarean delivery. Obstet. 2020.
Preterm birth was observed in 19 cases among the 48 for which information Crucial data are not doi:10.1002/ijgo.13166
on gestational age was available (39.6%; 95% CI, 25.8-54.7). In only two available for vaginal
cases, delivery was due to spontaneous preterm labor. Eleven newborns delivery. Breastfeeding
with respiratory disease and two newborns testing positive for SARS‐CoV‐2 was not generally
by real‐time RT‐PCR assay were reported. In three neonates, SARS‐CoV‐2 IgG reported, thus the risk
and IgM levels were elevated, but the RT‐PCR test was negative. The rate of of transmission during
vertical or peripartum transmission of SARS‐CoV‐2 is low, if any, for cesarean breastfeeding is
delivery; no data are available for vaginal delivery. unknown.
Neonatal 8-Apr-20 Neonatal American Clinical Opinion Pregnant women and newborns represent a vulnerable population in the This article provides a Chandrasekharan P, Vento
resuscitation, Resuscitation Journal of global COVID-19 pandemic. However, the precise impact of this novel virus comprehensive M, Trevisanuto D, et al.
post- and Post- Perinatology on the fetus and neonate remains uncertain. There is some disagreement overview of Neonatal Resuscitation and
resuscitation resuscitation among experts on an optimal approach to protect health care workers and recommendations for Postresuscitation Care of
care, Care of Infants newborns during and after delivery by a COVID-19. Decisions must be based perinatal management Infants Born to Mothers
pregnancy, Born to Mothers on resource availability, surge volume, and potential risk of transmission. of pregnant women with Suspected or
perinatal with Suspected This manuscript outlines the precautions and steps to be taken before, with confirmed COVID- Confirmed SARS-CoV-2
management, or Confirmed during, and after resuscitation of a newborn born to a COVID-19 mother, 19 and newborns. Infection [published online,
breastfeeding SARS-CoV-2 including three optional variations of current standards involving shared- Parents should be 2020 Apr 8]. Am J Perinatol.
Infection. decision making with parents for perinatal management, resuscitation of the engaged in shared 2020. doi:10.1055/s-0040-
newborn, disposition, nutrition, and post-discharge care. The availability of decision-making with 1709688
resources may also drive the application of these guidelines. More evidence options for rooming in,
and research are needed to assess the risk of vertical and horizontal skin-to-skin contact,
transmission of SARS-CoV-2 and its impact on fetal and neonatal outcomes. and breastfeeding.
Neonatal 8-Apr-20 Novel European Research Letter Previous studies have described the clinical features of COVID-19 in adults Based on four cases of Zhang ZJ, Yu XJ, Fu T, et al.
infection, Coronavirus Respiratory and infants under 1 year of age. Little is known about features, outcomes neonatal infection, Novel Coronavirus Infection
clinical Infection in Journal and intrauterine transmission potential in newborns aged 28 days or less. neonates appear in Newborn Babies Under
characteristics, Newborn Babies Through systematic searching, authors identified 4 infections in newborns in susceptible to COVID-19 28 Days in China [published
China Under 28 Days in China as of March 13, 2020. The age range was 30 hours to 17 days old. but experience milder online, 2020 Apr 8]. Eur
China Three were male. One newborn had fever and cough, 1 had fever only, 1 had symptoms than adults. Respir J. 2020;2000697.
shortness of breath, and 1 had no symptoms. Supportive treatment was doi:10.1183/13993003.0069
provided for all 4 newborns. None required intensive unit care or mechanical 7-2020
ventilation. Three newborns recovered by the end of this study. All 4
mothers were infected with SARS-CoV-2, 3 showing symptoms before and 1
61
after delivery. Cesarean section was used for all 4 deliveries. Three
newborns were separated from their mothers and were not breastfed. In
summary, newborns are susceptible to SARS-CoV-2 infection and present
milder symptoms and better outcomes compared to adults. Intrauterine
vertical transmission is possible, but direct evidence is still lacking.
Twin 6-Apr-20 COVID-19 in Acta Letter to the This case report describes a 34‐year‐old primipara with a dichorionic twin It is challenging to Gidlöf S, Savchenko
pregnancy, pregnancy with Obstetricia et Editor pregnancy, who was hospitalized at 36+2/7 weeks' gestation, due to discriminate between J, Brune T, Josefsson H.
gestational comorbidities: Gynecolo-gica hypertension and proteinuria. On admission, a nasopharyngeal SARS-CoV-2 common complications COVID-19 in pregnancy with
diabetes, high- More liberal Scandinavica RNA test was taken. Several hours later, an emergency cesarean section was of high‐risk pregnancies comorbidities: More liberal
risk pregnancy, testing strategy performed, and two female newborns were delivered in good condition. with comorbidities (e.g. testing strategy is needed
breast milk sam is needed Following delivery, the mother's RT-PCR test was determined to be positive gestational diabetes, [published online, 2020 Apr
ple, maternal for SARS-CoV-2 infection. Due to the mother's gestational diabetes preeclampsia) from 6].
vaginal (diagnosed at 29 weeks), the twin neonates were fed with formula, and COVID‐19. Neonatal Acta Obstet Gynecol Scand.
secretion breastfeeding was initiated simultaneously. Both twins had negative nasopharyngeal swabs, 2020.
sample nasopharyngeal SARS-CoV-2 RNA tests, taken at 34 hours and 4.5 days of maternal doi:10.1111/aogs.13862
age. Breastmilk and maternal vaginal secretion samples also tested negative breast milk and vaginal
on the fifth day. secretions all tested
negative for SARS-CoV-
2.
Breastfeeding, 6-Apr-20 Breast Feeding at Archives of Letter This letter responds to a recent commentary by Li et al. promoting the Protocols applied in Davanzo R. Breast feeding
expressed the Time of Disease in isolation of all infants with suspected COVID-19 regardless of whether or not maternity hospitals to at the time of COVID-19: do
mother's milk, COVID-19: Do Children: Fetal they present with symptoms, without details on the management of prevent COVID-19 not forget expressed
neonatology, Not Forget & Neonatal newborn feeding. Other Chinese colleagues have discouraged the use of should consider the mother's milk, please
neonatal Expressed Edition expressed breast milk for infants with suspected COVID-19. In Switzerland, promotion of [published online, 2020 Apr
management, Mother's Milk, Favre et al. suggested the avoidance of direct breastfeeding by COVID-19 breastfeeding without 6]. Arch Dis Child Fetal
mother- Please positive mothers due to close contact and potential aerosol disregarding the Neonatal Ed. 2020.
infant relations transmission. However, it is important to consider that the primary feasible option of doi:10.1136/archdischild-
hip concern for risk of transmission is by respiratory droplets, which can be expressing 2020-319149
mitigated through basic preventive measures, not by breastmilk. Second, the mother's milk.
practice of routine maternal-neonatal separation penalizes
their relationship. The use of expressed mother's milk should be considered
as a second choice, to rescue the nutritional benefits of
breast milk when direct breastfeeding is not recommended. Lastly, in light of
limited evidence, breastmilk may contain specific
antibodies that modulate eventual SARS-CoV-2 infection.
Breastfeeding 3-Apr-20 Breastfeeding Maternal & Review Article Recommendations from the Italian Society of Neonatology indicate that for Recommendations from Davanzo R, Moro G, Sandri
indications, and Coronavirus Child a mother with suspected or confirmed COVID-19 who is asymptomatic or Italy align with WHO F, Agosti M, Moretti
Italy, Europe Disease-2019. Ad Nutrition pauci-symptomatic at delivery, rooming-in is feasible and direct guidelines surrounding C, Mosca F. Breastfeeding
interim breastfeeding is advisable under strict measures of infection control. breastfeeding with and Coronavirus Disease-
indications of the However, when a mother with COVID-19 is too sick to care for the newborn, COVID-19. 2019. Ad interim indications
Italian Society of the neonate should be managed separately and fed fresh expressed of the Italian Society of
Neonatology breast milk, with no need to pasteurize it since human milk is not believed to Neonatology endorsed by
endorsed by the be a vehicle of COVID-19. This guidance is subject to change. the Union of European
Union of Neonatal & Perinatal
European Societies [published online,
Neonatal & 2020 Apr
3]. Matern Child Nutr. 2020;
62
Perinatal e13010.
Societies. doi:10.1111/mcn.13010
Breastfeeding, 3-Apr-20 Safe Handling of Journal of Insights into COVID-19 virus contaminates surfaces from respiratory droplet spread. For This report provides Marinelli KA, Lawrence RM.
donor milk, Containers of Human Practice and known coronaviruses, viral lifespan ranges up to 9 days, depending on detailed information on Safe Handling of Containers
donor milk ban Expressed Lactation Policy volume of inoculation, material inoculated, temperature, and humidity. recommended of Expressed Human Milk in
king, breast Human Milk in van Doremalen et al. (2020) found that SARS-CoV-2 was more stable on disinfection procedures all Settings During the SARS-
pump, surface all Settings plastic and stainless steel than on copper and cardboard; viable virus was for CoV-2 (COVID-19) Pandemic
contamination, During the SARS- detected up to 72 hours after application to these surfaces although the breast milk containers, [published online, 2020 Apr
disinfection CoV-2 (COVID- virus titer was greatly reduced. Since mothers express their milk into a among other hygiene 3]. J Hum Lact. 2020.
19) Pandemic variety of plastic or glass containers, inadvertent viral spread must be precautions for mothers doi:10.1177/089033442091
avoided during container transfer to milk banks or other locations, through expressing milk. 9083
handwashing guidelines before and after expressing milk. Containers must
be disinfected after milk expression with viricidal agents or appropriate
bleach solutions (such as "high level disinfection" of 0.5% sodium
hypochlorite solution, according to WHO) before storage in milk banks,
hospital wards, day care centers, or similar locations.
Pregnancy, 1-Apr-20 An New England Correspondence A 34-year-old woman presented to the labor and delivery unit with a 3-day This case describes an Iqbal SN, Overcash R,
uncomplicated Uncomplicated Journal of history of fever, chills, dry cough, and myalgia. She reported decreased fetal uncomplicated, vaginal Mokhtari N, et al. An
delivery, Delivery in a Medicine movements during the past day. Chest radiographs showed reticular delivery of a healthy Uncomplicated Delivery in a
neonate, Patient with interstitial opacities, and laboratory tests were unremarkable except for neonate in a woman Patient with Covid-19 in the
United States Covid-19 in the lymphopenia. Tests for COVID-19 were determined to be positive 21 hours with COVID-19. Skin-to- United States [published
United States after samples were obtained. On hospital day 3, she had an uncomplicated skin contact was not online, 2020 Apr 1]. N Engl J
spontaneous vaginal delivery. Delayed cord clamping was not performed, allowed. The neonate Med. 2020.
and skin-to-skin contact between the mother and infant was not permitted. was isolated following doi:10.1056/NEJMc2007605
There was no evidence of neonatal or intra-amniotic infection. The neonate delivery and fed with
was moved to a separate room and remained there until discharge. The formula and expressed
neonate was fed with formula and expressed breast milk. breast milk.
Children, 1-Apr-20 COVID-19 Virus Archives Editorial As of March 3, 2020, there are more than 900 confirmed pediatric cases, but Based on existing Morand A, Fabre
asymptomatic, and Children: de Pédiatrie currently no child under 10 years of age has died; only one individual knowledge around A, Minodier P, et al. COVID-
clinical What Do We between 10 and 19 years of age died, and only one child under 1 year old COVID-19 in children, 19 virus and children: What
characteristics, Know? was reported to have a severe form of the disease. The number of confirmed this article raises the do we know?. Arch Pediatr.
breastfeeding pediatric cases is very low, and the severity and mortality rates are even question of whether 2020;27(3):117–
lower, compared to adults. There is no systematic sampling series in children represent less 118. doi:10.1016/j.arcped.2
asymptomatic persons, and the age distribution of asymptomatic patients is severe cases, are less 020.03.001
not detailed in the literature. Do children represent less severe cases, are infected, or are being
they less infected, or are they being underdiagnosed as less underdiagnosed
symptomatic? Symptoms in children include fever, pneumonia, and upper as asymptomatic?
respiratory signs. Symptomatic care is often sufficient, but antibiotic Breastfeeding is
treatment of bacterial superinfection may be necessary. A higher risk of encouraged with
preterm birth is reported in pregnant women, and maternal infection could appropriate hygiene
be involved in neonatal distress; one neonate died, but his specimens precautions.
tested negative for COVID-19 by RT-PCR. Breastfeeding, with proper hygiene
precautions, should be encouraged. If a mother is too tired to
breastfeed, milk should be expressed using breast pumps so that a healthy
caregiver may feed the infant.
63
NICU, 1-Apr-20 U.S. NICUs and The Lancet Reflections On March 28, 2020, the first infant death of the U.S. outbreak was This Furlow, B. US NICUs and
donor milk Donor Milk Bank Child & announced in Illinois. The U.S. CDC recommends separating newborns from article discusses concer donor milk banks brace for
bank, s Brace for Adolescent mothers with suspected or confirmed COVID-19. Disruptions in ns related to COVID-19. Lancet Child
breastfeeding, COVID-19 Health breastfeeding could increase babies' risk of developing necrotizing breastfeeding, & Adol Health. 2020.
skin-to-skin enterocolitis (NEC), a life-threatening gastrointestinal emergency that can donor milk supply, and s https://doi.org/10.1016/S23
contact, United lead to gut perforation and sepsis. Hospital visitor restrictions have further kin-to-skin touch during 52-4642(20)30103-6
States, CDC, reduced newborns' opportunities for skin-to-skin touch and holding. In the COVID-19
WHO contrast with the CDC, WHO guidance on breastfeeding suggests that pandemic. The
women with COVID-19 should breastfeed their newborns if they want to do author notes that
so, while emphasizing respiratory hygiene (mask wearing, handwashing). human milk lowers risk
Pasteurized donor milk is a vital resource for babies in NICUs whose mothers for newborn necrotizing
cannot provide breast milk, but donor supplies have become a concern as enterocolitis thus
states and cities issue stay-at-home orders. Hospitals have begun disruptions in
precautionary rationing, allocating donor milk to the smallest and most at- breastfeeding may lead
risk preterm infants to prevent NEC. to GI emergencies.
Infant, isolation 1-Apr-20 Environment and Annals of Letter SARS-CoV-2 is suspected to spread from an infected person to a susceptible Findings suggest that Yung CF, Kam KQ, Wong
room, personal Personal Internal host primarily through droplets and possibly direct contact. The roles of SARS-CoV-2 positive MSY, et al. Environment and
protective Protective Medicine transmission by indirect contact (fomites) or by long-range airborne route infants with no Personal Protective
equipment, Equipment Tests are uncertain. In this letter, authors investigate environmental respiratory symptoms, Equipment Tests for SARS-
breastfeeding, for SARS-CoV-2 contamination and potential for transmission from a 6-month-old infant can contaminate nearby CoV-2 in the Isolation Room
hygiene in the Isolation with COVID-19, admitted for isolation. The isolation environment and PPE of environments. Hand of an Infant With Infection
precautions Room of an a health care worker were sampled and tested using PCR. The infant's hygiene when caring for [published online, 2020 Apr
Infant With bedding, cot rail, and table (where baby formula and wipes were placed) infants with COVID-19 is 1]. Ann Intern Med.
Infection. situated 1 meter away were found to be positive for SARS-CoV-2, confirming important to reduce 2020;M20-0942.
that an infant with COVID-19 but without respiratory symptoms can environmental doi:10.7326/M20-0942
contaminate the environment through crying or drooling. There was a contamination.
downward trend of viral load with increasing distance from the infant.
Despite close physical contact with the infant during feeding, no evidence of
SARS-CoV-2 was detected on the health care worker's gown.
Breastfeeding, 30-Mar-20 International Journal of Insights into Based on personal communications with colleagues in China, Italy, and the This article discusses Marinelli KA. International
donor milk, Perspectives Human Practice and author's own donor milk bank in the United States, the author has the effects of the Perspectives Concerning
donor milk ban Concerning Lactation Policy attempted to document the pandemic's current effect on COVID-19 crisis on Donor Milk Banking During
king, China, Donor Milk Banki donor milk banking as well as donor milk supply and demand. There is donor milk banking and the SARS-CoV-2 (COVID-19)
Italy, United ng During the heightened anxiety in donors who must interact with the healthcare system details programmatic Pandemic [publis+H7hed
States SARS-CoV-2 to have their blood drawn for screening, or when they drop off their milk at changes and emergency online ahead of print, 2020
(COVID-19) the milk bank. The author's organization is engaged in educating mothers preparedness strategies Mar 30]. J Hum Lact. 2020.
Pandemic that there is no evidence of coronavirus transmission through implemented at a non- doi:10.1177/089033442091
human milk and that previous coronaviruses have been destroyed by profit U.S. milk bank to 7661
pasteurization. Other milk banking organizations have issued statements ensure sustained supply
upholding the importance of donor milk and recommending the addition of of donor milk, transport
questions about risk of COVID-19 exposure to donor screening protocols, as of "safe" milk from
well as deferral of donors who report symptoms or test positive for SARS- donors to milk banks
CoV-2. under quarantine, and
support for
breastfeeding
mothers.
64
Serological 26-Mar-20 Antibodies in JAMA Research Letter New serological diagnostic criteria (released by the Chinese National Health This research builds Zeng H, Xu C, Fan J, et al.
testing, vertical Infants Born to Commission on Mar 4) were applied to a cohort of 6 pregnant women with upon an earlier cohort Antibodies in Infants Born
transmission, Mothers With confirmed COVID-19, admitted to Zhongnan Hospital, Wuhan from February study of nine pregnant to Mothers With COVID-19
IgM / IgG COVID-19 16 to March 6, 2020. All six mothers had mild clinical manifestations women from the same Pneumonia [published
concentrations, Pneumonia and cesarean deliveries in their third trimester in negative pressure isolation hospital (Chen et al, Feb online ahead of print, 2020
cytokine levels, rooms. Infants were isolated from their mothers immediately after delivery. 2020), and contributes Mar 26].
China While neonatal throat swabs and blood samples tested negative for viral new data on serological JAMA. 2020;e204861.
nucleic acid by RT-PCR, virus-specific antibodies were detected in the blood characteristics of doi:10.1001/jama.2020.486
serum of all six infants. IgG concentrations (passively transferred across the mothers and newborns. 1
placenta beginning in the second trimester) were elevated in six infants (not The presence of anti-
usually passively transferred), and IgM concentrations were detected in two SARS-CoV-2 IgM in 2
infants. Abnormal weight and pathology of placentas in mothers with SARS infants suggests
have been noted (Ng et al, 2006), but placental damage among women in possible transplacental
this study is unknown. IgM could have been produced by the fetus if the transmission. Study is
virus crossed the placenta. Inflammatory cytokine IL-6 was also significantly limited by lack of
increased in all neonatal sera samples. cord blood, amniotic
fluid, and
breast milk data.
Serological 26-Mar-20 Possible Vertical JAMA Research Letter This case report describes the birth of an infant with elevated anti-SARS- Elevated IgM levels in a Dong L, Tian J, He S, et al.
testing, Transmission of CoV-2 IgM antibodies and cytokine levels, despite no physical contact with a neonate born to a Possible Vertical
breastmilk sam SARS-CoV-2 mother with laboratory-confirmed COVID-19. The mother developed COVID- mother with confirmed Transmission of SARS-CoV-2
ple, vertical From an Infected 19 symptoms and was admitted to Renmin Hospital, Wuhan on January 28, COVID-19 raise From an Infected Mother to
transmission, Mother to Her 2020, where she received antiviral, antibiotic, corticosteroid, and oxygen suspicion of Her Newborn [published
IgM / IgG Newborn therapies. RT-PCR tests of the patient's vaginal secretions were negative. An transmission in utero. online ahead of print, 2020
concentrations, infant girl was delivered on February 22, 2020 by cesarean section in a However, the infant's Mar 26].
cytokine levels, negative pressure isolation room; she was immediately quarantined in the repeatedly negative RT- JAMA. 2020;e204621.
China NICU. At two hours of age, the neonate had elevated IgG and IgM levels PCR test results are doi:10.1001/jama.2020.462
(usually appear 3 to 7 days after infection) and abnormal cytokine test difficult to explain. 1
results. Mother's breastmilk tested negative by RT-PCR on February 28, but Study limitations
her antibody levels were still elevated one day later. Elevated IgM antibody include lack of amniotic
levels in the neonate suggest that she was infected in utero, during the 23 fluid or placenta
days from the time of the mother's diagnosis to delivery. The elevated IgG testing. Infection at
level may reflect maternal or infant infection. delivery cannot be ruled
out.
Pregnancy, 26-Mar-20 Experience of Current Article During breastfeeding, close attention must be paid to hygiene of hands and These guidelines from Wang SS, Zhou X, Lin XG, et
newborn Clinical Medical breasts. Suspected and confirmed cases of COVID-19 are not recommended Tongji Hospital (based al. Experience of Clinical
management, Management for Science to breastfeed, according to clinicians at Tongji Hospital. Breastfeeding is not on the New Diagnosis Management for Pregnant
nursing, Pregnant suggested while taking lopinavir/ritonavir, which can be secreted in and Treatment Scheme Women and Newborns with
breastfeeding, Women and the milk of rates. During the suspension of breastfeeding, it is recommended for Novel Coronavirus Novel Coronavirus
neonatal Newborns with that the mother empties her breasts regularly. Newborns who have been Infected Pneumonia, Pneumonia in Tongji
isolation, China Novel confirmed or are suspected of having SARS-CoV-2 infection should be Trial Edition 5) are Hospital, China [published
Coronavirus transferred to an isolation ward for observation or treatment. Only when the consistent with earlier online ahead of print, 2020
Pneumonia in mother is found negative on two consecutive nucleic acid tests, and under recommendations Mar 26]. Curr Med Sci.
Tongji Hospital, informed consent, should the mother and child be in the same room. against breastfeeding 2020. doi:10.1007/s11596-
China. for mothers with 020-2174-4
COVID-19, from other
Chinese institutions.
65
Pregnancy, 23-Mar-20 Coronavirus American Special Report To date, the outcomes of 55 pregnant women and 46 neonates infected with There is no definitive Dashraath P, Jing Lin Jeslyn
pathophysiolog Disease 2019 Journal of COVID-19 have been reported in the literature, with no concrete evidence of evidence of vertical W, Mei Xian Karen L, et al.
y, vertical (COVID-19) Obstetrics & vertical transmission. Physiological and mechanical changes in pregnancy transmission, but skin- Coronavirus Disease 2019
transmission, Pandemic and Gynecology increase susceptibility to infections in general, particularly when the to-skin contact should (COVID-19) Pandemic and
breastfeeding, Pregnancy cardiorespiratory system is affected. Pregnancy bias towards Th2 system be avoided following Pregnancy [published online
skin-to-skin dominance, which protects the fetus, leaves the mother vulnerable to viral delivery. Breastfeeding ahead of print, 2020 Mar
contact infections, which are more effectively contained by the Th1 system. is not contraindicated, 23]. Am J Obstet Gynecol.
Although data doesn't suggest risk of vertical transmission, delayed clamping but a face mask should 2020. doi:10.1016/j.ajog.20
of the umbilical cord and skin-to-skin contact should be avoided following be worn. 20.03.021
delivery. Breastfeeding is not contraindicated based on retrospective
analysis of COVID-19 in pregnancy that showed absence of detectable viral
loads of SARS-CoV-2 in breastmilk. Regardless, a face mask should be worn
due to the close proximity between mother and child to reduce the risk of
droplet transmission. The presence of coronavirus antibodies in
breastmilk depends on the gestation at which maternal infection occurred
and if there was any preceding use of high-dose corticosteroids which could
suppress maternal antibody responses.
Infant, 23-Mar-20 The first infant The Lancet Case Report A 3-month-old, female patient presented with mild upper respiratory Unlike earlier reported Le HT, Nguyen LV, Tran DM,
secondary case of COVID-19 Child & symptoms and fever. Her nasopharyngeal swab samples tested positive for cases in China, this et al. The first infant case of
transmission, acquired from a Adolescent SARS-CoV-2 by RT-PCR. She was exclusively breastfed, and her patient was the COVID-19 acquired from a
Vietnam secondary Health immunizations were up to date. The infection was transmitted secondarily youngest member in secondary transmission in
transmission in from a close contact with confirmed COVID-19 in the family. However, unlike her family cluster to Vietnam [published online,
Vietnam reported family clusters where the youngest child was not infected or acquire disease. 2020 Mar 23]. Lancet Child
asymptomatic, this patient was the youngest member in the family who Adolesc Health. 2020.
acquired the disease with symptoms. doi:10.1016/S2352-
4642(20)30091-2
Perinatal 17-Mar-20 Perinatal Clinical Brief Report This paper presents two cases of COVID-19 associated SARS-CoV-2 infection Authors bring up the Cuifang Fan, Di
transmission, Transmission of Infectious during the third trimester of pregnancy. Newborns showed no abnormalities potential protective Lei, Congcong Fang et al.,
breastmilk sam COVID-19 Diseases at birth, and mothers had excellent outcomes. It is possible that mothers effect of neutralizing Perinatal Transmission of
ples, Associated SARS- developed sufficient neutralizing antibodies, without developing serious antibodies transmitted COVID-19 Associated SARS-
breastfeeding, CoV-2: Should conditions. These antibodies may have a passively protective effect on to newborns through CoV-2: Should
neutralizing We Worry? children through breastfeeding. Despite the fact that SARS-CoV-2 was not breastmilk, however We Worry?, Clinical
antibodies detected in consecutive breastmilk or neonatal specimens, breastfeeding breastfeeding was still Infectious Diseases, 17
was still discouraged. discouraged for the March 2020, ciaa226,
mothers with COVID-19 https://doi.org/10.1093/cid
in this report. /ciaa226
Neonatal 17-Mar-20 A 55-Day-Old The Journal of Brief Report A 55-day-old, otherwise healthy, female infant that received mixed feeding In line with previous Cui, Y, Tian M, Huang D et
infection, Female Infant Infectious became ill January 28, 2020. The infant and her parents had contact with studies, al. A 55-Day-Old Female
pneumonia, infected with Diseases relatives who had symptoms like cough and fever 10 days before. The child’s breastmilk samples Infant infected with COVID
liver injury, COVID 19: parents were diagnosed with COVID-19 on January 31, and three from a mother with 19: presenting with
heart damage, presenting with consecutive tests of SARS-CoV-2 RNA in the breast milk of the mother were SARS-CoV-2 infection pneumonia, liver injury, and
breastmilk sam pneumonia, liver negative between February 2 to February 4. tested negative. heart damage, The Journal
ple injury, and heart of Infectious Diseases, 17
damage March 2020, jiaa113,
https://doi.org/10.1093/inf
dis/jiaa113
66
Pregnancy, 16-Mar-20 Infants Born to Frontiers in Case Report This case report describes the birth of four full-term infants born to pregnant Consistent with growing Chen Y, Peng H, Wang L,
neonatal Mothers With a Pediatrics Article women with laboratory-confirmed COVID-19 in Wuhan, Hubei province, literature, there is no Zhao Y,Zeng L, Gao H and
infection, New Coronavirus China. Of three infants with test results, none tested positive for the virus. evidence of vertical Liu Y. Infants Born to
formula (COVID-19). None developed serious clinical symptoms. Two infants had rashes of transmission. Placenta, Mothers With a
feeding, vertical unknown etiology at birth, and one had facial ulcerations. One infant had amniotic fluid, neonatal NewCoronavirus (COVID-
transmission, tachypnea and was supported by non-invasive mechanical ventilation for 3 blood, gastric fluid, and 19). 2020. Front. Pediatr.
China days. One had rashes at birth but was discharged without parental consent anal swabs tested 8:104. doi:
for a diagnostic test. All four infants are doing well and have been formula negative for viral RNA. 10.3389/fped.2020.00104
feeding since birth.
Pregnancy, 13-Mar-20 What are the The Lancet Review This article reviews a small number of published cases that have analyzed This article re-states the Qiao J. What are the risks of
neonates, risks of COVID-19 COVID-19 in pregnant women and neonates, discussing expert findings from other case COVID-19 infection in
infection infection in recommendations for infection control among confirmed cases. studies on COVID-19 in pregnant women?. Lancet.
control pregnant pregnant women and 2020;395(10226):760–762.
women? neonates. doi:10.1016/S0140-
6736(20)30365-2
Neonatal 12-Mar-20 A case report of Clinical Brief Report A neonate tested positive for COVID-19 infection by RT-PCR assay, using In line with previous Wang, S., Guo, L., Chen, L.,
infection neonatal COVID- Infectious pharyngeal samples, 36 hours after delivery via emergency cesarean section. studies, there was no Liu, W., Cao, Y., Zhang, J., &
19 infection in Diseases The mother was wearing an N95 mask throughout the operation, and the concrete evidence of Feng, L. (2020). A case
China. infant had no contact with the mother after birth. Breastfeeding was vertical transmission, report of neonatal COVID-
discouraged, while emptying her breasts of milk was encouraged to avoid and the 19 infection in China.
mastitis. The mother’s breast milk sample, which was collected 36 hours breast milk samples Clinical Infectious Diseases,
after birth, tested negative for the virus. from a mother with 12 March 2020, ciaa225,
confirmed COVID-19 https://doi.org/10.1093/cid
tested negative. /ciaa225
Breastfeeding, r 9-Mar-20 Breastfeeding Lactation Commentary Remdesivir shows promising activity against COVID-19. Nothing is known Little is known about Anderson, P. O. (2020).
emdesivir, and Respiratory Medicine about the passage of remdesivir into breast milk, but one infant with Ebola the passage of antivirals Breastfeeding and
antiviral Antivirals: was treated with IV remdesivir following treatment with the monoclonal (including those Respiratory Antivirals:
therapy, Coronavirus and antibody ZMapp and a buffy coat transfusion from an Ebola survivor. The suggested to treat Coronavirus and Influenza.
influenza, Influenza. infant experienced no adverse effects and was virus free on day 20 of life. COVID-19) into Breastfeeding
Ebola breastmilk. Medicine. doi:10.1089/bfm.
2020.29149.poa
Vertical 5-Mar-20 Lack of vertical Emerging Research Letter A 30-year-old pregnant woman, confirmed positive for SARS-CoV-2 infection, Sputum samples from a Li Y, Zhao R, Zheng S, Chen
transmission, transmission of Infectious delivered an infant by cesarean section at 35 weeks gestation, in a negative- woman with confirmed X, Wang J, Sheng X, et al.
pregnancy, severe acute Diseases pressure operating room. An oropharyngeal swab specimen, obtained COVID-19 tested Lack of vertical transmission
breastmilk sam respiratory immediately after the infant was taken from the uterus, indicated that the positive following of severe acute respiratory
ple, placenta syndrome infant was negative for SARS-CoV-2, and was sent to the negative-pressure delivery, while amniotic syndrome coronavirus 2,
sample, China coronavirus 2, ward. On the delivery day, although the woman’s sputum was positive, fluid, umbilical cord China. Emerging infectious
China. serum, urine, feces, amniotic fluid, umbilical cord blood and placenta, and blood, placenta, and diseases, 26(6). 5 March
breast milk samples were negative. breast milk samples 2020.
tested negative. https://doi.org/10.3201/eid
2606.200287
67
Pregnancy, 5-Mar-20 Novel Ultrasound in Opinion This paper discusses the current guidelines in China that recommend As noted in other Yang, H., Wang, C., & Poon,
neonatal coronavirus Obstetrics & newborn separation from their infected mothers for at least 14 days protocols from China, L. C. (2020). Novel
infection infection and Gynecology following birth. These restrictions make direct breastfeeding unfeasible; breastfeeding is coronavirus infection and
pregnancy. however, the mothers are advised to express their breastmilk in order to discouraged while pregnancy. Ultrasound in
maintain milk production. Once they test negative for COVID‐19, they should breastmilk expression is Obstetrics & Gynecology. 5
be encouraged to breastfeed their infant. encouraged in order to March 2020.
maintain milk productio https://doi.org/10.1002/uo
n. g.22006
Pregnancy, 5-Mar-20 Novel corona Acta Obstetric Special Editorial This editorial presents a set of recommendations based on WHO, CDC, and The guidelines in this Liang H, Acharya G. Novel
WHO, CDC, virus disease ia et Gynecolo expert Chinese guidance, with regard to prevention, diagnosis, editorial fall in line with corona virus disease
expert (COVID-19) in gica Scandinav management, timing and mode of delivery, and care of infants born to previously stated (COVID-19) in pregnancy:
guidance, pregnancy: What ica mothers with COVID-19. Limited data suggests that transplacental Chinese guidance What clinical
China clinical transmission is unlikely in late pregnancy, but infection can occur in on breastfeeding recommendations to
recommendation neonates via close contact. Early cord clamping and temporary separation of but contradict the follow?
s to follow? the newborn for at least 2 weeks is recommended. During this period, direct WHO's Acta Obstet Gynecol Scand.
breast feeding is not recommended, but a mother can pump her breast milk, recommendations to 2020;99(4):439–442.
which can be used to feed the neonate by a healthy caregiver. allow mothers with doi:10.1111/aogs.13836
COVID-19 to choose to
continue to
breastfeed.
Neonates, 4-Mar-20 Proposal for Archives of Letter This article outlines recommendations regarding newborns: Infants with Recommendations Li F, Feng ZC, Shi Y. Proposal
prevention, prevention and Disease in highly suspected or confirmed COVID-19 should be referred to the outlined in this letter for prevention and control
infection control of the Childhood - designated neonatal ward. All medical staff involved should wear protective discourage of the 2019 novel
control, 2019 novel Fetal and equipment. The neonatal department should be strictly stratified into breastfeeding until after coronavirus disease in
breastfeeding coronavirus Neonatal transitional, quarantine, living and work areas. Infants with suspected recovery. newborn infants Archives of
disease in Edition infections should be isolated in a single room, while confirmed patients Disease in Childhood - Fetal
newborn infants should be moved into separate rooms. After admission, avoiding and Neonatal Edition
breastfeeding from COVID-19 mother until recovery should be adequately Published Online First: 04
performed. March 2020. doi:
10.1136/archdischild-2020-
318996
Pregnancy, viral 3-Mar-20 Guidelines for The Lancet Correspondence This guideline points out that newborns of mothers confirmed positive for Authors do not Favre, G., Pomar, L., Qi, X.,
shedding, pregnant women Infectious SARS-CoV-2 should be isolated for at least 14 days or until viral shedding recommend direct Nielsen-Saines, K., Musso,
breastfeeding with suspected Diseases clears, during which time direct breastfeeding is not recommended. breastfeeding for D., & Baud, D. (2020).
SARS-CoV-2 newborns of mothers Guidelines for pregnant
infection. confirmed positive for women with suspected
SARS-CoV-2. SARS-CoV-2 infection. The
Lancet Infectious Diseases.
03 March 2020.
https://doi.org/10.1016/S14
73-3099(20)30157-2
68
Infant, viral 28-Feb-20 A Well Infant Clinical Brief Report A well 6-month-old boy was referred to KK Women’s and Children’s Hospital Breastmilk samples, Kai-qian Kam, Chee Fu Yung,
load, with Coronavirus Infectious (KKH) on February 4, 2020, and a nasopharyngeal specimen taken on collected from a Lin Cui, Raymond Lin Tzer
nasopharynx, Disease 2019 Diseases admission and tested by RT-PCR confirmed the diagnosis of COVID-19 breastfeeding mother Pin, Tze Minn Mak,
breastmilk sam (COVID-19) with infection. His mother’s symptoms started on January 29, 2020 and the first with confirmed COVID- Matthias Maiwald, Jiahui Li,
ple High Viral Load nasopharyngeal swab on February 3, 2020 was positive for SARS-CoV-2. 19 infection, tested Chia Yin Chong,
Breastmilk samples on February 8, 2020 were negative. The infant likely negative several days Karen Nadua, Natalie Woon
acquired the virus from a household member, but it was difficult to ascertain after her diagnosis. Hui Tan, Koh Cheng Thoon,
the day of infection as there were no reported symptoms. A Well Infant with
Coronavirus Disease 2019
(COVID-19) with High Viral
Load. Clinical Infectious
Diseases, 28 February 2020,
ciaa201,
https://doi.org/10.1093/cid
/ciaa201
Pregnancy, 28-Feb-20 A case of 2019 Clinical Brief Report On February 2, 2020, a 28-year-old female, who was 30 weeks pregnant, A report from a hospital Wang, X., Zhou, Z., Zhang, J.,
infant, Novel Infectious presented to a fever clinic of Suzhou Municipal Hospital with intermittent in China describes Zhu, F., Tang, Y., Shen, X., &
premature Coronavirus in a Diseases fever for one week. Two throat swab samples were collected and tested management of a Shen, X. (2020). A case of
birth pregnant woman negative. On February 6, the second SARS-CoV-2 RT-PCR results of her newborn with 2019 Novel Coronavirus in a
with preterm sputum came back positive. A preterm male infant was delivered at 30 confirmed COVID-19, pregnant woman with
delivery weeks of pregnancy. On day 3 after cesarean section, RT-PCR analyses of the who was isolated from preterm delivery. Clinical
neonatal throat swab and stool samples were COVID-19 negative. He was his mother and fed Infectious Diseases, 28
kept in the isolation ICU of the neonatal nursery for observation, without formula, rather than February 2020, ciaa200,
any contact with his mother after birth. The newborn was given formula breastmilk. https://doi.org/10.1093/cid
instead of breast milk ever since. Samples of breastmilk were not taken for Breastmilk samples for /ciaa200
testing. testing were notably
missing.
Pregnancy, 25-Feb-20 Coronavirus Preprints Case Series This case series was conducted in the obstetric ward of Tongji Hospital. This case series Liu, W.; Wang, Q.; Zhang,
perinatal Disease 2019 Systematic testing for SARS-CoV-2 infection included oropharyngeal swab, presents the most Q.; Chen, L.; Chen, J.; Zhang,
infection, (COVID-19) placenta tissue, vaginal mucus, and breast milk of mothers, as well as comprehensive virologi B.; Lu, Y.; Wang, S.; Xia, L.;
breast milk sam During oropharyngeal swab, umbilical cord blood, and serum of newborns. All cal assessment of Huang, L.; Wang, K.; Liang,
ple, vertical Pregnancy: A patients showed an uneventful perinatal course, successful outcomes, and pregnant women and L.; Zhang, Y.; Turtle, L.;
transmission Case Series. no evidence of vertical transmission. newborns to date. Lissauer, D.; Lan, K.; Feng,
There was no evidence L.; Yu, H.; Liu, Y.; Sun, Z.
of vertical Coronavirus Disease 2019
transmission. (COVID-19) During
Pregnancy: A Case Series.
Preprints 2020,
2020020373
Pregnancy, 24-Feb-20 Coronavirus American Jour Expert Review This expert review draws upon information on other pathogenic In a 2004 report on Rasmussen
obstetrics, Disease 2019 nal of coronaviruses (SARS, MERS) to provide insight into effects of COVID-19 on SARS-CoV testing of SA, Smulian JC, Lednicky JA,
coronaviruses, (COVID-19) and Obstetrics & pregnancy. A single report of SARS-CoV testing of breastmilk (approximately breastmilk, antibodies Wen TS, Jamieson DJ.
SARS- Pregnancy: What Gynecology 130 days after illness onset) exists: no viral RNA was detected, but SARS- were detected, but viral Coronavirus Disease 2019
CoV antibodies Obstetricians CoV antibodies were seen (Robertson et al, 2004). In another patient with RNA was not. Expert (COVID-19) and Pregnancy:
in breastmilk Need to Know SARS-CoV, at 7 weeks gestation, antibodies were not seen when authors recommend What obstetricians need to
breastmilk was tested at postpartum days 12 and 30 (Stockman et al, that breastfeeding know [published online
2004). Until additional data are available, mothers who are well enough to should be initiated after ahead of print, 2020 Feb
69
express breastmilk should be encouraged to do so; breastfeeding can be a mother is no longer 24]. Am J Obstet Gynecol.
instituted after she is no longer infectious. infectious. 2020. doi:10.1016/j.ajog.20
20.02.017
Neonatal 16-Feb-20 SARS-CoV-2 Chinese Case Study in A neonate with SARS-CoV-2 infection presented with initial symptoms of Neonates may present Wang J, Wang D, Chen GC,
infection, infection with Journal of Mandarin; vomiting and milk refusal. After two weeks of treatment at Wuhan with primarily Tao XW, Zeng
gastrointestinal gastrointestinal Contemporary Abstract in Children's Hospital, the patient gradually recovered and was discharged. gastrointestinal LK. Zhongguo Dang
symptoms, symptoms as Pediatrics English symptoms (such Dai Er Ke Za Zhi.
clinical first as milk refusal and 2020;22(3):211–214.
manifestation, manifestation in vomiting), rather than
China a neonate respiratory symptoms.
Pregnancy, 12-Feb-20 Clinical The Lancet Original Article This article presents a retrospective review of laboratory results and CT No evidence for Chen, H., Guo, J., Wang, C.,
vertical characteristics scans from nine pregnant women with COVID-19 pneumonia admitted intrauterine infection Luo, F., Yu, X., Zhang, W., ...
transmission, and intrauterine to Zhongnan Hospital of Wuhan University from Jan 20 to Jan 31, 2020. All caused by vertical & Liao, J. (2020). Clinical
breastmilk sam vertical women tested positive for SARS-CoV-2 by use of quantitative RT-PCR (qRT- transmission in women characteristics and
ple, China transmission PCR) on samples from the respiratory tract. The nine pregnant women were who develop COVID-19 intrauterine vertical
potential of in their third trimester, and all underwent caesarean section. Six samples of pneumonia in late transmission potential of
COVID-19 amniotic fluid, cord blood, neonatal throat swab, and breastmilk collected pregnancy. Six COVID-19 infection in nine
infection in nine after their first lactation tested negative for the presence of SARS-CoV-2, breastmilk samples pregnant women: a
pregnant using both the CDC-recommended test kit and the in-house tested RT-PCR tested negative for viral retrospective review of
women: a assays. nucleic acid. medical records. The Lancet
retrospective 2020 Feb 12, 395(10226),
review of 809-815. [e-pub].
medical records. https://doi.org/10.1016/S01
40-6736(20)30360-3
Neonatal 11-Feb-20 2019-novel Chinese Case Study in An infant was breastfed after birth, with normal growth and good health This case study Zhang, Y. H., Lin, D. J., Xiao,
infection, coronavirus Journal of Mandarin; status. The infant was admitted to a hospital in Xiaogan, Hubei Province, on raises the question of M. F., Wang, J. C., Wei, Y.,
breastmilk sam infection in a Pediatrics Abstract in January 26, 2020 and continued to be breastfed. She tested positive for shorter incubation Lei, Z. X., ... & Xiang, W.
ple, China three-month-old English COVID-19 one day later. Nasopharyngeal swab specimens collected from the periods in neonates (2020). 2019-novel
baby parents on January 26 initially tested negative, but the parents were compared to adults. coronavirus infection in a
diagnosed with infection one week later. In this case, viral nucleic acid was Notably, three-month-old baby.
detected in the stool of the mother, but no viral nucleic acid was detected in breastmilk samples Chinese journal of
breastmilk or urine. tested negative for viral pediatrics, 2020 Feb
nucleic acid. 11;58(0):E006. DOI:
10.3760/cma.j.issn.0578-
1310.2020.0006.
Perinatal and 6-Feb-20 Chinese expert Annals of Expert The possibility of the vertical transmission of 2019-nCoV cannot be ruled Chinese expert Wang L, Shi Y, Xiao T et al.;
neonatal consensus on the Translational Consensus out. Infants should not be fed with breast milk from mothers with confirmed consensus recommends on behalf of the Working
management, perinatal and Medicine or suspected of 2019-nCoV. If the suspected or diagnosed mother and her that infants should not Committee on Perinatal and
prevention, neonatal breast milk test negative for 2019-nCoV, infants should be fed with be fed with Neonatal Management for
China management for breast milk. Donor milk can be considered for use after being screened for breast milk from the Prevention and Control
the prevention 2019-nCoV, because the virus may be excreted into the milk during the mothers with confirmed of the 2019 Novel
and control of incubation period. or suspected 2019- Coronavirus Infection.
the 2019 novel nCoV. Donor milk can Chinese expert consensus
coronavirus be considered after on the perinatal and
infection (First screening for 2019- neonatal management for
edition). nCoV. the prevention and control
of the 2019 novel
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coronavirus infection (First
edition). Ann Transl Med
2020;8(3):47. doi:
10.21037/atm.2020.02.20
Children, viral 4-Feb-20 Management Chinese Article in Under the organization of the Xiangya Hospital of Central South University, Clinicians Peng, J., Wang, X., Yang, M.
pneumonia, plan for Journal of Mandarin; the Department of Pediatrics has formulated an action plan at Xiangya Hospital in H., Wang, M. J., & Zheng, X.
pediatric prevention and Contemporary Abstract in with Xiangya unique model to prevent and control novel coronavirus China do not R. (2020). Management plan
management, control of novel Pediatrics English pneumonia (NCP) among children according to the current epidemic recommend for prevention and control
prevention, coronavirus situation and diagnostic and therapeutic program in China. For perinatal breastfeeding for of novel coronavirus
China pneumonia newborns, breastfeeding is not recommended for infants born to women infants born to women pneumonia among children
among children who are suspected or confirmed with NCP, but the women should with suspected or in Xiangya Hospital of
in Xiangya express milk regularly to ensure lactation. Breastfeeding is not feasible until confirmed COVID-19 Central South
Hospital of infected mothers are cured. pneumonia. Women University. Zhongguo dang d
Central South should ai er ke za zhi, 22(2), 100-
University. express milk regularly 105. 2020 Feb. DOI:
to ensure lactation. 10.7499/j.issn.1008-
8830.2020.02.004
Newborn 2-Feb-20 Emergency Chinese Article in For each infant admitted to the hospital, health workers ask his/her mother, This Pediatric Pediatric Committee.
management, response plan Journal of Mandarin; family members, caregivers, and people who have been in contact: 1) Committee's Emergency response plan
emergency for the neonatal Contemporary Abstract in whether they are 2019-nCoV confirmed or suspected cases; 2) whether they emergency response for the neonatal intensive
response plan, intensive care Pediatrics English visited an epidemic areas in the past 2 weeks, especially Wuhan, Hubei plan advises care unit during epidemic of
NICU, China unit during Province; 3) whether they have been in close contact with patients with against breastfeeding 2019 novel coronavirus.
epidemic of 2019 respiratory infections in the past 2 weeks; 4) whether they have been in for newborns who are Chinese journal of
novel close contact with wild animals in the past 2 weeks. If any of the above under observation for contemporary pediatrics,
coronavirus. conditions are met, the infant will be placed in a single room and observed 14 days, following 22(2), 91. 2020 Feb. DOI:
for 14 days. During the observation period, in order to reduce screening for exposure. 10.7499/j.issn.1008-
risk, breastfeeding by mothers confirmed with COVID-19 8830.2020.02.002
is not recommended.
Primary 1-Feb-20 Guidance on the Chinese Article in Mothers who are isolated at home, following evaluation by medical staff at a These guidelines Zhang D Y, Yao M, Wang J,
healthcare Control and General Mandarin; primary health institution, can continue breastfeeding, but they must wear pertain to breastfeeding et al. Guidance on the
settings, Prevention of Practice Abstract in medical masks properly and practice hand hygiene using soap and water or mothers during home Control and Prevention of
prevention SARS-CoV-2 English hand disinfectants containing alcohol. isolation. SARS-CoV-2 Infection in
guidance, rural Infection in Primary Healthcare Settings
China Primary in Rural China (First Edition).
Healthcare Chinese General Practice,
Settings in Rural 2020, 23(7): 763-769. DOI:
China (First 10.12114/j.issn.1007-
Edition). 9572.2020.00.246
Perinatal and 1-Feb-20 Perinatal and Chinese Article in Pregnant women with COVID-19 in critical condition should be isolated from This editorial from a Working Group for the
neonatal neonatal Journal of Mandarin; infants for 14 days after delivery. After the mother is cured, breastfeeding working group for the Prevention and Control of
management, management Contemporary Abstract in can be initiated. High-risk infants, including those who have been in close prevention and control Neonatal 2019-nCoV
prevention, plan for Pediatrics English contact with confirmed family members and caregivers, or have been of neonatal 2019-nCoV Infection in the Perinatal
China prevention and exposed to sources of infection in public places, are not recommended to in China states that Period of the Editorial.
control of 2019 breastfeed. If they are fed with donor milk, the milk should be pasteurized. breastfeeding should be Perinatal and neonatal
novel avoided for infants born management plan for
coronavirus to mothers with prevention and control of
confirmed COVID-19 2019 novel coronavirus
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Edition). mother is cured. Chinese Journal of
Contemporary Pediatrics,
2020, 22(2): 87-90. DOI:
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8830.2020.02.001
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